Provider Demographics
NPI:1194940791
Name:GAILEY, NATALIE JANE (CNP)
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:JANE
Last Name:GAILEY
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:NATALIE
Other - Middle Name:JANE
Other - Last Name:ARNOLD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNP
Mailing Address - Street 1:500 S TRIMBLE RD
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44906-4103
Mailing Address - Country:US
Mailing Address - Phone:419-756-6000
Mailing Address - Fax:
Practice Address - Street 1:500 S TRIMBLE RD
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44906-4103
Practice Address - Country:US
Practice Address - Phone:419-756-6000
Practice Address - Fax:419-756-1774
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2015-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA12935 NP363LW0102X
OHRN334993 COA1363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH341054437OtherTIN