Provider Demographics
NPI:1790494144
Name:NEVEDAL, NATHANIEL J
Entity Type:Individual
Prefix:
First Name:NATHANIEL
Middle Name:J
Last Name:NEVEDAL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:149 SHILOH RD STE 9
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59106-2775
Mailing Address - Country:US
Mailing Address - Phone:855-593-4357
Mailing Address - Fax:
Practice Address - Street 1:149 SHILOH RD STE 9
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59106-2775
Practice Address - Country:US
Practice Address - Phone:855-593-4357
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-15
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral