Provider Demographics
NPI:1629545462
Name:ROMAN, NATALIE NICOLE (FNP-C)
Entity Type:Individual
Prefix:MS
First Name:NATALIE
Middle Name:NICOLE
Last Name:ROMAN
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 1:190 ABNER JACKSON PKWY STE 200
Mailing Address - Street 2:
Mailing Address - City:LAKE JACKSON
Mailing Address - State:TX
Mailing Address - Zip Code:77566-5169
Mailing Address - Country:US
Mailing Address - Phone:979-529-2520
Mailing Address - Fax:979-529-2537
Practice Address - Street 1:190 ABNER JACKSON PKWY STE 220
Practice Address - Street 2:
Practice Address - City:LAKE JACKSON
Practice Address - State:TX
Practice Address - Zip Code:77566-5170
Practice Address - Country:US
Practice Address - Phone:979-549-1218
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-30
Last Update Date:2021-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP139503363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily