Provider Demographics
NPI:1245124726
Name:MOSTACADA, NATALIE (AGCNS-BC)
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:
Last Name:MOSTACADA
Suffix:
Gender:F
Credentials:AGCNS-BC
Other - Prefix:
Other - First Name:NATALIE
Other - Middle Name:
Other - Last Name:MOSTACADA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:AGCNS-BC
Mailing Address - Street 1:480 MEDICAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43210-1229
Mailing Address - Country:US
Mailing Address - Phone:614-293-3333
Mailing Address - Fax:
Practice Address - Street 1:480 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43210-1229
Practice Address - Country:US
Practice Address - Phone:614-293-3333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-07
Last Update Date:2025-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNS.0019520364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistGroup - Single Specialty