Provider Demographics
NPI:1629535190
Name:STAGGS, NATOSHA LEIGH (BSN, RN)
Entity Type:Individual
Prefix:MRS
First Name:NATOSHA
Middle Name:LEIGH
Last Name:STAGGS
Suffix:
Gender:F
Credentials:BSN, RN
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1735 27TH ST STE B06
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:OH
Mailing Address - Zip Code:45662-2681
Mailing Address - Country:US
Mailing Address - Phone:606-796-0010
Mailing Address - Fax:606-796-0011
Practice Address - Street 1:246 COMMONWEALTH ROAD
Practice Address - Street 2:
Practice Address - City:VANCEBURG
Practice Address - State:KY
Practice Address - Zip Code:41179
Practice Address - Country:US
Practice Address - Phone:606-796-0010
Practice Address - Fax:606-796-0011
Is Sole Proprietor?:No
Enumeration Date:2019-02-21
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.025212363L00000X
KY3017813363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0372392Medicaid
KY7100629020Medicaid