Provider Demographics
NPI:1023761327
Name:GARRISON, NATASHA (APRN)
Entity type:Individual
Prefix:
First Name:NATASHA
Middle Name:
Last Name:GARRISON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3191 KY 1232
Mailing Address - Street 2:
Mailing Address - City:GRAY
Mailing Address - State:KY
Mailing Address - Zip Code:40734-6818
Mailing Address - Country:US
Mailing Address - Phone:606-260-2246
Mailing Address - Fax:
Practice Address - Street 1:3191 KY 1232
Practice Address - Street 2:
Practice Address - City:GRAY
Practice Address - State:KY
Practice Address - Zip Code:40734-6818
Practice Address - Country:US
Practice Address - Phone:606-260-2246
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-27
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3017084363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner