Healthcare Provider Details

I. General information

NPI: 1033896915
Provider Name (Legal Business Name): NATALIYA HURSKAYA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/30/2023
Last Update Date: 06/30/2023
Certification Date: 02/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24197 STATESBORO PL
ASHBURN VA
20148-1775
US

IV. Provider business mailing address

24197 STATESBORO PL
ASHBURN VA
20148-1775
US

V. Phone/Fax

Practice location:
  • Phone: 404-512-1322
  • Fax:
Mailing address:
  • Phone: 404-512-1322
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: