Provider Demographics
NPI:1700564093
Name:ARMSTRONG, NATHANAEL VINCENT
Entity Type:Individual
Prefix:MR
First Name:NATHANAEL
Middle Name:VINCENT
Last Name:ARMSTRONG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58374 TOWNSHIP ROAD 1195
Mailing Address - Street 2:
Mailing Address - City:WEST LAFAYETTE
Mailing Address - State:OH
Mailing Address - Zip Code:43845-9718
Mailing Address - Country:US
Mailing Address - Phone:740-545-9547
Mailing Address - Fax:
Practice Address - Street 1:202 CHURCH ST
Practice Address - Street 2:
Practice Address - City:WARSAW
Practice Address - State:OH
Practice Address - Zip Code:43844-9024
Practice Address - Country:US
Practice Address - Phone:740-545-9547
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-07
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
172A00000X, 347C00000X, 3747P1801X, 376J00000X, 253Z00000X, 347C00000X, 3747P1801X, 376J00000X, 253Z00000X
OHHTB8287343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No172A00000XOther Service ProvidersDriver
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate Vehicle
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No376J00000XNursing Service Related ProvidersHomemaker