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General NPI Number Information
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NPI Number | 1902495252
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Entity Type | Individual
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Provider Name | NATASHA STANLEY FNP
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Gender | Female
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Dates
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Enumeration Date | 01/12/2021
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Last Update Date | 01/12/2021
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Provider Practice Location Address
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Address Line | 205 E 19TH ST N
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City | BIG STONE GAP
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State | VA
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Zip | 24219-3468
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Country | US
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Telephone | 276-524-4920
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Fax | 276-524-4921
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Provider Business Mailing Address
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Address Line | PO BOX 1044
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City | BIG STONE GAP
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State | VA
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Zip | 24219-0930
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Country | US
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Telephone | 276-393-3110
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 0024180759
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License Number State | VA
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