Provider Demographics
NPI:1831549005
Name:ROSS, NATALIE (DNP, FNP-BC, RN)
Entity type:Individual
Prefix:DR
First Name:NATALIE
Middle Name:
Last Name:ROSS
Suffix:
Gender:F
Credentials:DNP, FNP-BC, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:W66N427 KENNEDY AVE
Mailing Address - Street 2:
Mailing Address - City:CEDARBURG
Mailing Address - State:WI
Mailing Address - Zip Code:53012-2322
Mailing Address - Country:US
Mailing Address - Phone:920-319-1097
Mailing Address - Fax:
Practice Address - Street 1:705 S UNIVERSITY AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:BEAVER DAM
Practice Address - State:WI
Practice Address - Zip Code:53916-3053
Practice Address - Country:US
Practice Address - Phone:920-885-6090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-17
Last Update Date:2016-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI201364-30163W00000X
WI7008-33363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse