Provider Demographics
NPI:1144422791
Name:MALDEN, NATASHA SHARRONDA (LPN)
Entity Type:Individual
Prefix:MRS
First Name:NATASHA
Middle Name:SHARRONDA
Last Name:MALDEN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2405 NAPIER DR
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76542-4649
Mailing Address - Country:US
Mailing Address - Phone:254-466-4585
Mailing Address - Fax:
Practice Address - Street 1:2405 NAPIER DR
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76542-4649
Practice Address - Country:US
Practice Address - Phone:254-466-4585
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPN5154590164W00000X
TX185587164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered164W00000XNursing Service ProvidersLicensed Practical Nurse
Not Answered164X00000XNursing Service ProvidersLicensed Vocational Nurse