Provider Demographics
NPI:1306807375
Name:CONWAY, NATALIE (PT, MPT, OCS, ATC)
Entity type:Individual
Prefix:MRS
First Name:NATALIE
Middle Name:
Last Name:CONWAY
Suffix:
Gender:F
Credentials:PT, MPT, OCS, ATC
Other - Prefix:
Other - First Name:NATALIE
Other - Middle Name:
Other - Last Name:NUNES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 69030
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21264-9030
Mailing Address - Country:US
Mailing Address - Phone:757-873-2302
Mailing Address - Fax:757-873-2306
Practice Address - Street 1:6970 FOX HUNT LN
Practice Address - Street 2:
Practice Address - City:GLOUCESTER
Practice Address - State:VA
Practice Address - Zip Code:23061-5394
Practice Address - Country:US
Practice Address - Phone:757-694-8111
Practice Address - Fax:804-694-5574
Is Sole Proprietor?:No
Enumeration Date:2006-03-30
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305004066225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA192960OtherBCBS PHYSICAL THERAPY
VA8928525Medicaid
VA650016000OtherMEDICARE RAILROAD
VA5970253OtherAETNA
VA5970253OtherAETNA
VA650000202Medicare PIN