Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | ARNP2734882 | FL |
NPI | 1013102409 |
---|---|
Provider Name | Natalie Eudora Bastien |
First Address | Plant City, FL 33563-7136 |
Second Address | St Petersburg, FL 33713-7146 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/09/2007 |
Last Update Date | 09/07/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3087034 00 | (05) | FL |
ARNP2734882 | STATE LIC. (01) | FL |
DA5786 | RAILROAD MEDICARE GROUP NUMBER (01) | FL |