Provider Demographics
NPI:1962113415
Name:BRALEY, NATASHA ANASTASIA (A-GNP-C)
Entity type:Individual
Prefix:MS
First Name:NATASHA
Middle Name:ANASTASIA
Last Name:BRALEY
Suffix:
Gender:F
Credentials:A-GNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:248 BAKERS BRANCH RD
Mailing Address - Street 2:
Mailing Address - City:WAXAHACHIE
Mailing Address - State:TX
Mailing Address - Zip Code:75167-9060
Mailing Address - Country:US
Mailing Address - Phone:682-583-8100
Mailing Address - Fax:
Practice Address - Street 1:248 BAKERS BRANCH RD
Practice Address - Street 2:
Practice Address - City:WAXAHACHIE
Practice Address - State:TX
Practice Address - Zip Code:75167-9060
Practice Address - Country:US
Practice Address - Phone:682-583-8100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-06
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1098120363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology