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General NPI Number Information
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NPI Number | 1508679994
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Entity Type | Individual
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Provider Name | NATASHA NORTH FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 01/29/2025
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Last Update Date | 01/29/2025
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Provider Practice Location Address
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Address Line | 12906 STATE ROUTE 664 S STE A6
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City | LOGAN
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State | OH
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Zip | 43138-9262
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Country | US
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Telephone | 740-216-5028
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Fax |
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Provider Business Mailing Address
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Address Line | 10830 STATE ROUTE 664 N
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City | LOGAN
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State | OH
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Zip | 43138-8101
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Country | US
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Telephone | 740-438-8969
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN.CNP.0038569
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License Number State | OH
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