Provider Demographics
NPI:1063979110
Name:ADAMS, NATASHYA MARIE (FNP-C)
Entity type:Individual
Prefix:
First Name:NATASHYA
Middle Name:MARIE
Last Name:ADAMS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:NATASHYA
Other - Middle Name:MARIE
Other - Last Name:LAKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9 LUCIANO CT
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95928-3843
Mailing Address - Country:US
Mailing Address - Phone:530-990-4559
Mailing Address - Fax:
Practice Address - Street 1:2767 OLIVE HWY
Practice Address - Street 2:
Practice Address - City:OROVILLE
Practice Address - State:CA
Practice Address - Zip Code:95966-6118
Practice Address - Country:US
Practice Address - Phone:530-533-8500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-25
Last Update Date:2019-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP95011007363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily