Provider Demographics
NPI:1316020480
Name:ROCKWELL, NATALIE H (NP)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:H
Last Name:ROCKWELL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3511 VERDE VALLEY SCHOOL ROAD
Mailing Address - Street 2:
Mailing Address - City:SEDONA
Mailing Address - State:AZ
Mailing Address - Zip Code:86351-9521
Mailing Address - Country:US
Mailing Address - Phone:207-319-6568
Mailing Address - Fax:928-543-0121
Practice Address - Street 1:6446 STATE ROUTE 179
Practice Address - Street 2:SUITE 207B
Practice Address - City:SEDONA
Practice Address - State:AZ
Practice Address - Zip Code:86351
Practice Address - Country:US
Practice Address - Phone:207-319-6568
Practice Address - Fax:928-543-0121
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME032992367A00000X
AZAP8582363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME1024140000Medicaid
MEME0199Medicare PIN