Provider Demographics
NPI:1275187668
Name:DUNKELBERG, NATALIE JOCELYNNE NICOLE
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:JOCELYNNE NICOLE
Last Name:DUNKELBERG
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:NATALIE
Other - Middle Name:JOCELYNNE NICOLE
Other - Last Name:DUNKELBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:KEDROW
Mailing Address - Street 1:32100 TELEGRAPH RD
Mailing Address - Street 2:
Mailing Address - City:BINGHAM FARMS
Mailing Address - State:MI
Mailing Address - Zip Code:48025-2452
Mailing Address - Country:US
Mailing Address - Phone:248-712-4266
Mailing Address - Fax:
Practice Address - Street 1:32100 TELEGRAPH RD
Practice Address - Street 2:
Practice Address - City:BINGHAM FARMS
Practice Address - State:MI
Practice Address - Zip Code:48025-2452
Practice Address - Country:US
Practice Address - Phone:248-712-4266
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-24
Last Update Date:2019-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156F00000XEye and Vision Services ProvidersTechnician/Technologist