Provider Demographics
NPI:1588973911
Name:GILL, NATALIE ANNE (NP-C)
Entity type:Individual
Prefix:MRS
First Name:NATALIE
Middle Name:ANNE
Last Name:GILL
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6801 BRECKSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:OH
Mailing Address - Zip Code:44131-5032
Mailing Address - Country:US
Mailing Address - Phone:216-636-8742
Mailing Address - Fax:216-636-7877
Practice Address - Street 1:6801 BRECKSVILLE RD
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:OH
Practice Address - Zip Code:44131-5032
Practice Address - Country:US
Practice Address - Phone:216-636-8742
Practice Address - Fax:216-636-7877
Is Sole Proprietor?:No
Enumeration Date:2010-10-04
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNP-11584363LA2200X
OHRN285057163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0207207Medicaid
OH3108327Medicaid
OH0207207Medicaid
OH3108327Medicaid