Provider Demographics
NPI:1790342459
Name:WIER, NATALIE BROOKE (RDMS, RVT)
Entity Type:Individual
Prefix:MRS
First Name:NATALIE
Middle Name:BROOKE
Last Name:WIER
Suffix:
Gender:F
Credentials:RDMS, RVT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5704 SHACKELFORD CT
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65203-4521
Mailing Address - Country:US
Mailing Address - Phone:573-882-6016
Mailing Address - Fax:
Practice Address - Street 1:5704 SHACKELFORD CT
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65203-4521
Practice Address - Country:US
Practice Address - Phone:573-882-6016
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-28
Last Update Date:2019-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
335V00000X, 2471S1302X
MO2471V0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonography
No335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier
No2471V0105XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistVascular Sonography