Provider Demographics
NPI:1952920621
Name:CARUTH, NATASHA (FNP)
Entity Type:Individual
Prefix:
First Name:NATASHA
Middle Name:
Last Name:CARUTH
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 478
Mailing Address - Street 2:
Mailing Address - City:BARTONSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18321-0478
Mailing Address - Country:US
Mailing Address - Phone:570-276-0643
Mailing Address - Fax:
Practice Address - Street 1:32 WATERVIEW BOULEVARD
Practice Address - Street 2:SUITE A
Practice Address - City:PARSIPPANY
Practice Address - State:NJ
Practice Address - Zip Code:07705-7611
Practice Address - Country:US
Practice Address - Phone:862-362-1030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-13
Last Update Date:2022-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ01022100363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily