Provider Demographics
NPI:1528337839
Name:WHEELER, NATALIE ELOWEN (LPN)
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:ELOWEN
Last Name:WHEELER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 CLAPP AVE
Mailing Address - Street 2:
Mailing Address - City:WAPPINGERS FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12590-3131
Mailing Address - Country:US
Mailing Address - Phone:914-382-2769
Mailing Address - Fax:
Practice Address - Street 1:30 CLAPP AVE
Practice Address - Street 2:
Practice Address - City:WAPPINGERS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12590-3131
Practice Address - Country:US
Practice Address - Phone:914-382-2769
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-16
Last Update Date:2011-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY307505-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse