Basic Information
| Provider Information | |||||||||
| NPI: | 1073030821 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | EVERS | ||||||||
| FirstName: | NATALIE | ||||||||
| MiddleName: | ELISE | ||||||||
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| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | KREUZ | ||||||||
| OtherFirstName: | NATALIE | ||||||||
| OtherMiddleName: | ELISE | ||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | PO BOX 403 | ||||||||
| Address2: | |||||||||
| City: | HIRAM | ||||||||
| State: | OH | ||||||||
| PostalCode: | 442340403 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4404772058 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 4255 NORTHFIELD RD | ||||||||
| Address2: | |||||||||
| City: | HIGHLAND HILLS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441282811 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2162929700 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/23/2017 | ||||||||
| LastUpdateDate: | 11/25/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | OT009848 | OH | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.