Provider Demographics
NPI:1912493339
Name:BEYER, NATALIE ISABELLA
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:ISABELLA
Last Name:BEYER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5319 S SICILY WAY
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80015-6589
Mailing Address - Country:US
Mailing Address - Phone:951-473-7984
Mailing Address - Fax:
Practice Address - Street 1:5319 S SICILY WAY
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80015-6589
Practice Address - Country:US
Practice Address - Phone:951-473-7984
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-09
Last Update Date:2018-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAR57772687OtherANTHEM BLUE CROSS BLUE SHIELD PPO