Provider Demographics
NPI:1588103295
Name:DOUGLAS, NATOSHA T (CRNP)
Entity type:Individual
Prefix:MRS
First Name:NATOSHA
Middle Name:T
Last Name:DOUGLAS
Suffix:
Gender:F
Credentials:CRNP
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Mailing Address - Street 1:2337 HOMER CLAYTON DRIVE
Mailing Address - Street 2:
Mailing Address - City:GUNTERSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35976
Mailing Address - Country:US
Mailing Address - Phone:256-582-5131
Mailing Address - Fax:256-582-1100
Practice Address - Street 1:5730 US HIGHWAY 431
Practice Address - Street 2:
Practice Address - City:ALBERTVILLE
Practice Address - State:AL
Practice Address - Zip Code:35950-0234
Practice Address - Country:US
Practice Address - Phone:256-907-9700
Practice Address - Fax:256-907-9724
Is Sole Proprietor?:No
Enumeration Date:2017-02-14
Last Update Date:2021-04-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL1-121705363LF0000X
ALF1216493363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily