Provider Demographics
NPI:1619922846
Name:RIOS, NATALIE (RN, CPNP)
Entity Type:Individual
Prefix:MS
First Name:NATALIE
Middle Name:
Last Name:RIOS
Suffix:
Gender:F
Credentials:RN, CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:269 FISH POND RD
Mailing Address - Street 2:
Mailing Address - City:SEWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:08080-3047
Mailing Address - Country:US
Mailing Address - Phone:856-863-9999
Mailing Address - Fax:
Practice Address - Street 1:646 KINGS HWY
Practice Address - Street 2:
Practice Address - City:WEST DEPTFORD
Practice Address - State:NJ
Practice Address - Zip Code:08096-3145
Practice Address - Country:US
Practice Address - Phone:856-879-2887
Practice Address - Fax:856-879-2855
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-24
Last Update Date:2016-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP009902363LP0200X
NJ26NJ00016300363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics