Provider Demographics
NPI:1942324306
Name:FERON, NATHALIE PAULE
Entity Type:Individual
Prefix:
First Name:NATHALIE
Middle Name:PAULE
Last Name:FERON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:NATHALIE
Other - Middle Name:PAULE
Other - Last Name:SATO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:77-224 MALIKO ST
Mailing Address - Street 2:
Mailing Address - City:KAILUA KONA
Mailing Address - State:HI
Mailing Address - Zip Code:96740-4470
Mailing Address - Country:US
Mailing Address - Phone:808-987-9908
Mailing Address - Fax:
Practice Address - Street 1:77-224 MALIKO ST
Practice Address - Street 2:
Practice Address - City:KAILUA KONA
Practice Address - State:HI
Practice Address - Zip Code:96740-4470
Practice Address - Country:US
Practice Address - Phone:808-987-9908
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMAT# 5961225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist