Provider Demographics
NPI:1578125787
Name:GADISON, NATASHA RENEE
Entity Type:Individual
Prefix:
First Name:NATASHA
Middle Name:RENEE
Last Name:GADISON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4375 ANNA DR
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38109-5503
Mailing Address - Country:US
Mailing Address - Phone:901-406-8948
Mailing Address - Fax:
Practice Address - Street 1:4375 ANNA DR
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38109-5503
Practice Address - Country:US
Practice Address - Phone:901-406-8948
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-08
Last Update Date:2019-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care