Provider Demographics
NPI:1053541920
Name:HUSSMANN, NATALIE A (PT)
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:A
Last Name:HUSSMANN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:NATALIE
Other - Middle Name:A
Other - Last Name:WEIHERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:PO BOX 5629
Mailing Address - Street 2:SUITE 102
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47716-5629
Mailing Address - Country:US
Mailing Address - Phone:812-401-3258
Mailing Address - Fax:812-401-3259
Practice Address - Street 1:225 CROSSLAKE DR
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47715-8198
Practice Address - Country:US
Practice Address - Phone:812-471-6677
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-24
Last Update Date:2016-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05009921A225100000X
KY006015225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000625967OtherBLUE CROSS BLUE SHIELD
IN201009940Medicaid
IN000000625967OtherBLUE CROSS BLUE SHIELD
IN201009940Medicaid