Provider Demographics
NPI:1639681919
Name:ANDERSON, NATASHA LEE (ACNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:NATASHA
Middle Name:LEE
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:ACNP-BC
Other - Prefix:MS
Other - First Name:NATASHA
Other - Middle Name:LEE
Other - Last Name:BABANATS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ACNP-BC
Mailing Address - Street 1:2096 MONTREAT CIR
Mailing Address - Street 2:
Mailing Address - City:VESTAVIA
Mailing Address - State:AL
Mailing Address - Zip Code:35216-3902
Mailing Address - Country:US
Mailing Address - Phone:205-948-5048
Mailing Address - Fax:
Practice Address - Street 1:6200 N LACHOLLA BLVD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85741
Practice Address - Country:US
Practice Address - Phone:520-469-8230
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-26
Last Update Date:2022-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY431194363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care