Provider Demographics
NPI:1194497388
Name:NEGRON LOPEZ, NATASHA A (RDN, LND)
Entity type:Individual
Prefix:MRS
First Name:NATASHA
Middle Name:A
Last Name:NEGRON LOPEZ
Suffix:
Gender:F
Credentials:RDN, LND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:A3 CALLE SIERRA LINDA
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-5410
Mailing Address - Country:US
Mailing Address - Phone:787-449-1790
Mailing Address - Fax:
Practice Address - Street 1:A3 CALLE SIERRA LINDA
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-5410
Practice Address - Country:US
Practice Address - Phone:787-449-1790
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-05
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR86116681133V00000X
PR2164133NN1002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR2164OtherLND
PR86116681OtherRDN