Provider Demographics
NPI:1427143569
Name:SEMON, NATALIE JANE (PT)
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:JANE
Last Name:SEMON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 44767
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85064-4767
Mailing Address - Country:US
Mailing Address - Phone:602-808-8989
Mailing Address - Fax:602-808-9494
Practice Address - Street 1:4800 N 44TH ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85018-3800
Practice Address - Country:US
Practice Address - Phone:602-808-8989
Practice Address - Fax:602-808-9494
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2021-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3563225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ71432Medicare PIN