Provider Demographics
NPI:1982991550
Name:SANTELLI, NATALIE CHRISTINE (OD, MAT)
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:CHRISTINE
Last Name:SANTELLI
Suffix:
Gender:F
Credentials:OD, MAT
Other - Prefix:
Other - First Name:NATALIE
Other - Middle Name:CHRISTINE
Other - Last Name:CROTHERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD, MAT
Mailing Address - Street 1:919 SAILORS REEF
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-3110
Mailing Address - Country:US
Mailing Address - Phone:970-372-9220
Mailing Address - Fax:970-221-4286
Practice Address - Street 1:5236 STRAUSS CABIN RD
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80528-9555
Practice Address - Country:US
Practice Address - Phone:970-372-9220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-05
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOPT.0002905152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
R160452Medicare UPIN