Provider Demographics
NPI:1871821611
Name:KEINATH, NATALIE MARIE (LPN)
Entity Type:Individual
Prefix:MRS
First Name:NATALIE
Middle Name:MARIE
Last Name:KEINATH
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:576 CLARENDON AVE
Mailing Address - Street 2:
Mailing Address - City:GALION
Mailing Address - State:OH
Mailing Address - Zip Code:44833-9330
Mailing Address - Country:US
Mailing Address - Phone:419-571-3515
Mailing Address - Fax:
Practice Address - Street 1:576 CLARENDON AVE
Practice Address - Street 2:
Practice Address - City:GALION
Practice Address - State:OH
Practice Address - Zip Code:44833-9330
Practice Address - Country:US
Practice Address - Phone:419-571-3515
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-04
Last Update Date:2009-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN-111334164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse