Provider Demographics
NPI:1316618713
Name:PIEHOTA, NATASHA L (MSN, BSN, RN)
Entity type:Individual
Prefix:
First Name:NATASHA
Middle Name:L
Last Name:PIEHOTA
Suffix:
Gender:F
Credentials:MSN, BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 CALM WATER WAY
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29486-6903
Mailing Address - Country:US
Mailing Address - Phone:717-380-7546
Mailing Address - Fax:
Practice Address - Street 1:4050 BRIDGE VIEW DR
Practice Address - Street 2:
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29405-7488
Practice Address - Country:US
Practice Address - Phone:843-953-0038
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-24
Last Update Date:2021-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC255585163WM0705X, 163WX0200X, 364SI0800X, 163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical
No163WX0200XNursing Service ProvidersRegistered NurseOncology
No364SI0800XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistInformatics