Provider / Organization | NPI | Date Certified |
---|---|---|
NATASHA NICOLE GOURLEY | 1699403832 | 2022-08-14 |
Natasha Nicole Gourley is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1699403832. Registration indicates Natasha Nicole Gourley is a provider of services with a specialization in Respiratory, Developmental, Rehabilitative and Restorative Service Providers, Specialist/Technologist (Specialist/Technologist: Athletic Trainer, ) (All Other Specialties & Provider Types, ) (Specialist/Technologist Athletic Trainer, Respiratory, Developmental, Rehabilitative and Restorative Service Providers) (Specialist/Technologist, )
Entity Type | Individual |
Provider Name | Natasha Nicole Gourley ATC, LAT, EMT-PM |
Practice Office Address | 504 N CLEVELAND ST MOUNT AYR, IA US |
Practice Office Telephone | 6413442707 |
Practice Office Fax | 6414644474 |
Mailing Address | 1260 COUNTY HIGHWAY J23 CLEARFIELD, IA 508408814 US |
Business Telephone | 6413442707 |
Business Fax | 6414644474 |
Code | Practice | License No State |
---|---|---|
2255A2300X PRIMARY | Respiratory, Developmental, Rehabilitative and Restorative Service Providers Specialist/Technologist Specialist/Technologist: Athletic Trainer All Other Specialties & Provider Types Specialist/Technologist Athletic Trainer Respiratory, Developmental, Rehabilitative and Restorative Service Providers Specialist/Technologist | 000693
IA |