Provider Demographics
NPI:1497022271
Name:HANNUM, NATALIE WORDEN (PT)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:WORDEN
Last Name:HANNUM
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:NATALIE
Other - Middle Name:
Other - Last Name:WORDEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:PO BOX 2852
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134
Mailing Address - Country:US
Mailing Address - Phone:303-840-1323
Mailing Address - Fax:303-416-4265
Practice Address - Street 1:19201 E. MAINSTREET #205
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134
Practice Address - Country:US
Practice Address - Phone:303-840-1323
Practice Address - Fax:303-416-4265
Is Sole Proprietor?:No
Enumeration Date:2011-11-22
Last Update Date:2020-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA27242225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist