Provider Demographics
NPI:1336517457
Name:PTASHINSKY, NATALYA (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:NATALYA
Middle Name:
Last Name:PTASHINSKY
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
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 786
Mailing Address - Street 2:
Mailing Address - City:IDYLLWILD
Mailing Address - State:CA
Mailing Address - Zip Code:92549-0786
Mailing Address - Country:US
Mailing Address - Phone:917-225-6302
Mailing Address - Fax:
Practice Address - Street 1:54910 PINE CREST AVENUE
Practice Address - Street 2:
Practice Address - City:IDYLLWILD
Practice Address - State:CA
Practice Address - Zip Code:92549-0786
Practice Address - Country:US
Practice Address - Phone:917-225-6302
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-05
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA794526363LA2200X, 363LG0600X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology