Provider Demographics
NPI:1073091286
Name:RAGSDALE, NATALIE ISBELL (APRN)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:ISBELL
Last Name:RAGSDALE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:NATALIE
Other - Middle Name:ISBELL
Other - Last Name:PUTNAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:300 E MCBEE AVE FL 4
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29601-2842
Mailing Address - Country:US
Mailing Address - Phone:864-522-8603
Mailing Address - Fax:
Practice Address - Street 1:200 FLEETWOOD DR STE 100
Practice Address - Street 2:
Practice Address - City:EASLEY
Practice Address - State:SC
Practice Address - Zip Code:29640-2022
Practice Address - Country:US
Practice Address - Phone:864-442-7618
Practice Address - Fax:864-442-7155
Is Sole Proprietor?:No
Enumeration Date:2018-07-31
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC21955363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
576000356OtherCORRECTIONAL FACILITY