Provider Demographics
NPI:1235872128
Name:TIKHONOVA, NATALIA (FNP-BC, BSN, NP)
Entity Type:Individual
Prefix:
First Name:NATALIA
Middle Name:
Last Name:TIKHONOVA
Suffix:
Gender:F
Credentials:FNP-BC, BSN, NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2312 OLD TOWNE RD
Mailing Address - Street 2:
Mailing Address - City:NAZARETH
Mailing Address - State:PA
Mailing Address - Zip Code:18064-1458
Mailing Address - Country:US
Mailing Address - Phone:443-413-3694
Mailing Address - Fax:
Practice Address - Street 1:188 MAIN ST
Practice Address - Street 2:
Practice Address - City:EMMAUS
Practice Address - State:PA
Practice Address - Zip Code:18049-4015
Practice Address - Country:US
Practice Address - Phone:888-264-3501
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-18
Last Update Date:2022-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP025287363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty