Provider Demographics
NPI:1659913481
Name:BERSTOCK, NATALIE A (AGACNP-BC)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:A
Last Name:BERSTOCK
Suffix:
Gender:F
Credentials:AGACNP-BC
Other - Prefix:
Other - First Name:NATALIE
Other - Middle Name:A
Other - Last Name:MLAKAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:78 WILDERNESS CT
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:VA
Mailing Address - Zip Code:22556-1027
Mailing Address - Country:US
Mailing Address - Phone:949-233-9718
Mailing Address - Fax:
Practice Address - Street 1:14085 CROWN CT
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22193-1458
Practice Address - Country:US
Practice Address - Phone:703-763-5224
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-14
Last Update Date:2019-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024178324363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care