Individual
NATALIE KIEL PROVENCHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2800 S HIGHLAND MESA RD APT 2-108, FLAGSTAFF, AZ 86001-7173
(520) 342-8264
Mailing address
2800 S HIGHLAND MESA RD APT 2-108, FLAGSTAFF, AZ 86001-7173
(520) 342-8264
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
08/16/2020
Last updated
08/16/2020
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