Provider Demographics
NPI:1609207422
Name:YOUNGBLOOD, NATASHA NICOLE (MSN, FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:NATASHA
Middle Name:NICOLE
Last Name:YOUNGBLOOD
Suffix:
Gender:F
Credentials:MSN, FNP-BC
Other - Prefix:MISS
Other - First Name:NATASHA
Other - Middle Name:NICOLE
Other - Last Name:CHANCEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:21770 KINGSLAND BLVD
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-2513
Mailing Address - Country:US
Mailing Address - Phone:281-646-0740
Mailing Address - Fax:
Practice Address - Street 1:21770 KINGSLAND BLVD
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-2513
Practice Address - Country:US
Practice Address - Phone:281-646-0740
Practice Address - Fax:281-646-0743
Is Sole Proprietor?:No
Enumeration Date:2013-12-04
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1106596363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily