Provider Demographics
NPI:1598318271
Name:VANVOLKENBURG, NATALIE GARNER (FNP-C)
Entity Type:Individual
Prefix:MISS
First Name:NATALIE
Middle Name:GARNER
Last Name:VANVOLKENBURG
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 1:1634 BLACKGUM LN
Mailing Address - Street 2:
Mailing Address - City:RIDGEWAY
Mailing Address - State:SC
Mailing Address - Zip Code:29130-9600
Mailing Address - Country:US
Mailing Address - Phone:678-906-1234
Mailing Address - Fax:
Practice Address - Street 1:29 BOULWARE RD
Practice Address - Street 2:
Practice Address - City:LUGOFF
Practice Address - State:SC
Practice Address - Zip Code:29078-9415
Practice Address - Country:US
Practice Address - Phone:678-906-1234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-22
Last Update Date:2020-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC23073363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily