Provider Demographics
NPI:1982290003
Name:VACHON, NATHALIE (APRN, FNP-C, FNP-BC)
Entity Type:Individual
Prefix:
First Name:NATHALIE
Middle Name:
Last Name:VACHON
Suffix:
Gender:F
Credentials:APRN, FNP-C, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10431 NW 24TH CT
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33322-2605
Mailing Address - Country:US
Mailing Address - Phone:954-605-4799
Mailing Address - Fax:
Practice Address - Street 1:10431 NW 24TH CT
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33322-2605
Practice Address - Country:US
Practice Address - Phone:954-605-4799
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-13
Last Update Date:2020-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2020129054363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily