Provider Demographics
NPI:1497461859
Name:FENNER, NATALIE (NP)
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:
Last Name:FENNER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:613 ESFUN TRCE
Mailing Address - Street 2:
Mailing Address - City:SANDY SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30328-8215
Mailing Address - Country:US
Mailing Address - Phone:561-635-7599
Mailing Address - Fax:
Practice Address - Street 1:5840 ROSWELL RD STE 900
Practice Address - Street 2:
Practice Address - City:SANDY SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30328-4980
Practice Address - Country:US
Practice Address - Phone:470-823-7842
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-27
Last Update Date:2025-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN281472363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily