Provider Demographics
NPI:1780138750
Name:GOMBAMI, NATASHA MARINA (CRNP)
Entity type:Individual
Prefix:MRS
First Name:NATASHA
Middle Name:MARINA
Last Name:GOMBAMI
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3053 RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH PARK
Mailing Address - State:PA
Mailing Address - Zip Code:15129-9333
Mailing Address - Country:US
Mailing Address - Phone:412-654-4383
Mailing Address - Fax:
Practice Address - Street 1:202 TIMBER RIDGE RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15238-2436
Practice Address - Country:US
Practice Address - Phone:724-580-8889
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-08
Last Update Date:2016-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN640091163W00000X
PASP016434363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse