Provider Demographics
NPI:1427326107
Name:BEGAYE, NATASHA
Entity type:Individual
Prefix:
First Name:NATASHA
Middle Name:
Last Name:BEGAYE
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:PO BOX 1864
Mailing Address - Street 2:
Mailing Address - City:FORT DEFIANCE
Mailing Address - State:AZ
Mailing Address - Zip Code:86504-1864
Mailing Address - Country:US
Mailing Address - Phone:928-729-5260
Mailing Address - Fax:
Practice Address - Street 1:MILE MAKER 34- ROUTE 12
Practice Address - Street 2:
Practice Address - City:FORT DEFIANCE
Practice Address - State:AZ
Practice Address - Zip Code:86504-1864
Practice Address - Country:US
Practice Address - Phone:928-729-5260
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-08
Last Update Date:2011-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD03115434343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)