MEDICARE: NATASHA LAUREN ECK DE CIPOLLA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	0110011743	VA

General Provider Information

NPI Number	:	1497610638
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NATASHA LAUREN ECK DE CIPOLLA

Provider Business Mailing Address
First Line	:	400 FOOTHILLS DR
Second Line	:
City	:	NELLYSFORD
State	:	VA
Zip	:	22958-8019
Country	:	US
Telephone Number	:	804-551-2663
Fax Number	:

Provider Business Practice Location Address
First Line	:	235 MARTIN LUTHER KING JR WAY
Second Line	:
City	:	HARRISONBURG
State	:	VA
Zip	:	22807-3275
Country	:	US
Telephone Number	:	804-551-2663
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/19/2025
Last Update Date	:	03/10/2026

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