Provider Demographics
NPI:1326703315
Name:REA, NATASHIA (REGISTERED NURSE)
Entity Type:Individual
Prefix:
First Name:NATASHIA
Middle Name:
Last Name:REA
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2501 WHITE PINE LN
Mailing Address - Street 2:
Mailing Address - City:MEBANE
Mailing Address - State:NC
Mailing Address - Zip Code:27302-8133
Mailing Address - Country:US
Mailing Address - Phone:478-955-1879
Mailing Address - Fax:
Practice Address - Street 1:2501 WHITE PINE LN
Practice Address - Street 2:
Practice Address - City:MEBANE
Practice Address - State:NC
Practice Address - Zip Code:27302-8133
Practice Address - Country:US
Practice Address - Phone:478-955-1879
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-03
Last Update Date:2021-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC300483163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse