Provider Demographics
NPI:1033314661
Name:WATERFALL, NATALIE MARIE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:NATALIE
Middle Name:MARIE
Last Name:WATERFALL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3801 SPRING CREEK RD
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MT
Mailing Address - Zip Code:59044-8900
Mailing Address - Country:US
Mailing Address - Phone:406-256-7375
Mailing Address - Fax:
Practice Address - Street 1:670 MAIN ST
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59105-3224
Practice Address - Country:US
Practice Address - Phone:406-245-6979
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2012-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT5613183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist