Provider Demographics
NPI:1912410655
Name:OSSINOVA, NATALIA ALEXANDROVNA (RN, BSN, IBCLC)
Entity type:Individual
Prefix:MS
First Name:NATALIA
Middle Name:ALEXANDROVNA
Last Name:OSSINOVA
Suffix:
Gender:F
Credentials:RN, BSN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:309 S STEWART ST
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-4016
Mailing Address - Country:US
Mailing Address - Phone:212-203-9394
Mailing Address - Fax:
Practice Address - Street 1:309 S STEWART ST
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-4016
Practice Address - Country:US
Practice Address - Phone:212-203-9394
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-15
Last Update Date:2017-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001248267163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant