Provider Demographics
NPI:1073738928
Name:SLOBODNIK, NATALIA V (FNP)
Entity Type:Individual
Prefix:MRS
First Name:NATALIA
Middle Name:V
Last Name:SLOBODNIK
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 980615
Mailing Address - Street 2:10105 HEARTHROCK CT
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23233
Mailing Address - Country:US
Mailing Address - Phone:804-828-6986
Mailing Address - Fax:804-828-7926
Practice Address - Street 1:1250 EAST MARSHALL ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23298-0615
Practice Address - Country:US
Practice Address - Phone:804-828-6986
Practice Address - Fax:804-828-7926
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024166827363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner