Provider Demographics
NPI:1366558074
Name:BOST, NATALIE B (FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:NATALIE
Middle Name:B
Last Name:BOST
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 751803
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28275-1803
Mailing Address - Country:US
Mailing Address - Phone:336-718-4820
Mailing Address - Fax:
Practice Address - Street 1:15235 JOHN J DELANEY DR STE B
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277-2846
Practice Address - Country:US
Practice Address - Phone:704-384-7300
Practice Address - Fax:704-384-7305
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2014-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC201629363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
2806952Medicare ID - Type Unspecified
NCP66544Medicare UPIN