Provider Demographics
NPI:1508679994
Name:NORTH, NATASHA (FNP-BC)
Entity type:Individual
Prefix:
First Name:NATASHA
Middle Name:
Last Name:NORTH
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10830 STATE ROUTE 664 N
Mailing Address - Street 2:
Mailing Address - City:LOGAN
Mailing Address - State:OH
Mailing Address - Zip Code:43138-8101
Mailing Address - Country:US
Mailing Address - Phone:740-438-8969
Mailing Address - Fax:
Practice Address - Street 1:12906 STATE ROUTE 664 S STE A6
Practice Address - Street 2:
Practice Address - City:LOGAN
Practice Address - State:OH
Practice Address - Zip Code:43138-9262
Practice Address - Country:US
Practice Address - Phone:740-216-5028
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-29
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0038569363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily