Provider Demographics
NPI:1912391293
Name:ALLEN, NATALIE (DPM)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:
Last Name:ALLEN
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:NATALIE
Other - Middle Name:
Other - Last Name:HOFFMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPM
Mailing Address - Street 1:60 SUMMERFIELD CT STE 102
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24019-4579
Mailing Address - Country:US
Mailing Address - Phone:540-904-1458
Mailing Address - Fax:561-548-1743
Practice Address - Street 1:60 SUMMERFIELD CT STE 102
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24019-4579
Practice Address - Country:US
Practice Address - Phone:540-904-1458
Practice Address - Fax:561-548-1743
Is Sole Proprietor?:No
Enumeration Date:2015-03-24
Last Update Date:2021-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0103301231213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1912391293Medicaid