Provider Demographics
NPI:1962116376
Name:BORCHARD, NATASHA (BSN, RN)
Entity type:Individual
Prefix:
First Name:NATASHA
Middle Name:
Last Name:BORCHARD
Suffix:
Gender:F
Credentials:BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11200 N 83RD AVE
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85345-5945
Mailing Address - Country:US
Mailing Address - Phone:623-486-6300
Mailing Address - Fax:
Practice Address - Street 1:11200 N 83RD AVE
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85345-5945
Practice Address - Country:US
Practice Address - Phone:623-486-6300
Practice Address - Fax:623-486-6369
Is Sole Proprietor?:No
Enumeration Date:2023-01-10
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ243259163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool