Provider Demographics
NPI:1427329614
Name:RALPH-NELSON, NATALIE (APN)
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:
Last Name:RALPH-NELSON
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:625 HILLSBOROUGH RD
Mailing Address - Street 2:
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:NJ
Mailing Address - Zip Code:08844-2913
Mailing Address - Country:US
Mailing Address - Phone:917-864-2776
Mailing Address - Fax:
Practice Address - Street 1:56 GEORGETOWN RD
Practice Address - Street 2:
Practice Address - City:BORDENTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08505-2405
Practice Address - Country:US
Practice Address - Phone:732-267-1971
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-19
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY306172363LA2200X
NJ26NJ00320200363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ26NJ00320200OtherDEA