Provider Demographics
NPI:1194966614
Name:NATIVIDAD, MARGARET JOHANNA (CRNP)
Entity type:Individual
Prefix:MS
First Name:MARGARET
Middle Name:JOHANNA
Last Name:NATIVIDAD
Suffix:
Gender:F
Credentials:CRNP
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Mailing Address - Street 1:1 ALPHA DR
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17022-2298
Mailing Address - Country:US
Mailing Address - Phone:717-361-1169
Mailing Address - Fax:717-361-1502
Practice Address - Street 1:1 ALPHA DR
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:PA
Practice Address - Zip Code:17022-2298
Practice Address - Country:US
Practice Address - Phone:717-361-1169
Practice Address - Fax:717-361-1502
Is Sole Proprietor?:No
Enumeration Date:2009-03-12
Last Update Date:2009-04-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAVP002238B363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily