Healthcare Provider Details

I. General information

NPI: 1619922846
Provider Name (Legal Business Name): NATALIE RIOS RN, CPNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/24/2006
Last Update Date: 05/16/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

646 KINGS HWY
WEST DEPTFORD NJ
08096-3145
US

IV. Provider business mailing address

269 FISH POND RD
SEWELL NJ
08080-3047
US

V. Phone/Fax

Practice location:
  • Phone: 856-879-2887
  • Fax: 856-879-2855
Mailing address:
  • Phone: 856-863-9999
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberSP009902
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number26NJ00016300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: