Provider Demographics
NPI:1407325947
Name:GIANNANTONIO, NATALIE T (FNP-C)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:T
Last Name:GIANNANTONIO
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 PLAZA DRIVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08757-3756
Mailing Address - Country:US
Mailing Address - Phone:732-341-1380
Mailing Address - Fax:732-505-9296
Practice Address - Street 1:3 PLAZA DRIVE
Practice Address - Street 2:SUITE 2
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08757-3756
Practice Address - Country:US
Practice Address - Phone:732-341-1380
Practice Address - Fax:732-505-9296
Is Sole Proprietor?:No
Enumeration Date:2018-11-14
Last Update Date:2019-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00868200363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily