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General NPI Number Information
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NPI Number | 1659913481
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Entity Type | Individual
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Provider Name | NATALIE A BERSTOCK AGACNP-BC
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Gender | Female
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Dates
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Enumeration Date | 10/14/2019
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Last Update Date | 10/14/2019
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Provider Practice Location Address
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Address Line | 14085 CROWN CT
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City | WOODBRIDGE
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State | VA
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Zip | 22193-1458
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Country | US
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Telephone | 703-763-5224
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Fax |
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Provider Business Mailing Address
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Address Line | 78 WILDERNESS CT
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City | STAFFORD
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State | VA
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Zip | 22556-1027
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Country | US
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Telephone | 949-233-9718
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 0024178324
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License Number State | VA
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