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General NPI Number Information
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NPI Number | 1033878574
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Entity Type | Individual
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Provider Name | NATHALIE DAGOBERT APRN
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Gender | Female
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Dates
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Enumeration Date | 12/13/2021
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Last Update Date | 12/21/2021
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Provider Practice Location Address
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Address Line | 505 S FEDERAL HWY
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City | DEERFIELD BEACH
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State | FL
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Zip | 33441-4109
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Country | US
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Telephone | 954-793-1176
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Fax |
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Provider Business Mailing Address
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Address Line | 7653 NW 79TH AVE APT 208
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City | TAMARAC
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State | FL
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Zip | 33321-2874
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Country | US
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Telephone | 954-793-1176
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | APRN11016932
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License Number State | FL
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