Provider Demographics
NPI:1700042462
Name:SINGLETON, NATALIE R (FNP-BC)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:R
Last Name:SINGLETON
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:NATALIE
Other - Middle Name:S
Other - Last Name:BAGWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-BC
Mailing Address - Street 1:106 JOHN ST
Mailing Address - Street 2:
Mailing Address - City:EASLEY
Mailing Address - State:SC
Mailing Address - Zip Code:29640-1415
Mailing Address - Country:US
Mailing Address - Phone:864-859-2220
Mailing Address - Fax:864-859-5744
Practice Address - Street 1:106 JOHN ST
Practice Address - Street 2:
Practice Address - City:EASLEY
Practice Address - State:SC
Practice Address - Zip Code:29640
Practice Address - Country:US
Practice Address - Phone:864-859-2220
Practice Address - Fax:864-859-5744
Is Sole Proprietor?:No
Enumeration Date:2008-08-01
Last Update Date:2010-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN126938363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA780457980AMedicaid
GA01228727OtherAMERIGROUP
GA464436OtherWELLCARE
GA780457980AMedicaid