Provider Demographics
NPI:1992181085
Name:HART, NATASHA BALLENTINE (PMHNP)
Entity Type:Individual
Prefix:MRS
First Name:NATASHA
Middle Name:BALLENTINE
Last Name:HART
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:MS
Other - First Name:NATASHA
Other - Middle Name:BALLENTINE
Other - Last Name:OBRIST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6701 PETERS CREEK RD STE 110
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24019-4060
Mailing Address - Country:US
Mailing Address - Phone:800-765-7130
Mailing Address - Fax:888-500-1891
Practice Address - Street 1:6701 PETERS CREEK RD STE 110
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24019-4060
Practice Address - Country:US
Practice Address - Phone:800-765-7130
Practice Address - Fax:888-500-1891
Is Sole Proprietor?:No
Enumeration Date:2015-07-30
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0017142327363LP0808X
VA0024172785363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health