Provider Demographics
NPI:1194370619
Name:NAVARRO, NATALIA LIZBETH
Entity Type:Individual
Prefix:
First Name:NATALIA
Middle Name:LIZBETH
Last Name:NAVARRO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 9170
Mailing Address - Street 2:
Mailing Address - City:NIKOLAI
Mailing Address - State:AK
Mailing Address - Zip Code:99691-0070
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2 SALMONBERRY ROAD
Practice Address - Street 2:
Practice Address - City:NIKOLAI
Practice Address - State:AK
Practice Address - Zip Code:99691
Practice Address - Country:US
Practice Address - Phone:907-293-2328
Practice Address - Fax:907-293-2330
Is Sole Proprietor?:No
Enumeration Date:2019-08-02
Last Update Date:2019-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK17-1456-11172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker