Provider Demographics
NPI:1912555004
Name:EDWARDS, NATALIE CHRISTINE
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:CHRISTINE
Last Name:EDWARDS
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 1:670 BOURBON ST UNIT 5
Mailing Address - Street 2:
Mailing Address - City:PAHRUMP
Mailing Address - State:NV
Mailing Address - Zip Code:89048-6175
Mailing Address - Country:US
Mailing Address - Phone:775-910-0547
Mailing Address - Fax:
Practice Address - Street 1:670 BOURBON ST UNIT 5
Practice Address - Street 2:
Practice Address - City:PAHRUMP
Practice Address - State:NV
Practice Address - Zip Code:89048-6175
Practice Address - Country:US
Practice Address - Phone:775-910-0547
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-31
Last Update Date:2019-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV00000446825Medicaid