Provider Demographics
NPI:1609047885
Name:ANDERSON, NATALIE CHAURIZE (RN)
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:CHAURIZE
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:188 WALZ RD
Mailing Address - Street 2:
Mailing Address - City:EAST BRANCH
Mailing Address - State:NY
Mailing Address - Zip Code:13756-2338
Mailing Address - Country:US
Mailing Address - Phone:607-363-2426
Mailing Address - Fax:
Practice Address - Street 1:188 WALZ RD
Practice Address - Street 2:
Practice Address - City:EAST BRANCH
Practice Address - State:NY
Practice Address - Zip Code:13756-2338
Practice Address - Country:US
Practice Address - Phone:607-363-2426
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-17
Last Update Date:2008-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY419742163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02226020Medicaid