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General NPI Number Information
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NPI Number | 1215681994
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Entity Type | Individual
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Provider Name | NATALIE NINA JAGARNAUTH
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Gender | Female
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Dates
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Enumeration Date | 02/10/2022
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Last Update Date | 02/10/2022
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Provider Practice Location Address
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Address Line | 401 NW 42ND AVE
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City | PLANTATION
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State | FL
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Zip | 33317-2835
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Country | US
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Telephone | 954-587-5010
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Fax |
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Provider Business Mailing Address
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Address Line | 10913 GALLERY ST
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City | BOCA RATON
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State | FL
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Zip | 33428-4025
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Country | US
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Telephone | 561-404-3587
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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 | APRN11017626
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License Number State | FL
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