Provider Demographics
NPI:1083465629
Name:CANGELOSI, NATASHA A (FNP-C)
Entity type:Individual
Prefix:
First Name:NATASHA
Middle Name:A
Last Name:CANGELOSI
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:NATASHA
Other - Middle Name:A
Other - Last Name:MINOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-C
Mailing Address - Street 1:27131 FULSHEAR BEND DR
Mailing Address - Street 2:
Mailing Address - City:FULSHEAR
Mailing Address - State:TX
Mailing Address - Zip Code:77441-1231
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4505 KINGWOOD DR STE 185
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77345-2618
Practice Address - Country:US
Practice Address - Phone:281-747-5534
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-01
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1170839363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner