Provider Demographics
NPI:1720342520
Name:WITTES, NATALIE ANNE (CRNP)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:ANNE
Last Name:WITTES
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:NATALIE
Other - Middle Name:ANNE
Other - Last Name:HORTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:615 CUMBERLAND ST
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:PA
Mailing Address - Zip Code:17042-5233
Mailing Address - Country:US
Mailing Address - Phone:717-273-6741
Mailing Address - Fax:717-273-6337
Practice Address - Street 1:615 CUMBERLAND ST
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:PA
Practice Address - Zip Code:17042-5233
Practice Address - Country:US
Practice Address - Phone:717-273-6741
Practice Address - Fax:717-273-6337
Is Sole Proprietor?:No
Enumeration Date:2012-06-27
Last Update Date:2015-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP014521363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily