Provider Demographics
NPI:1801773544
Name:ANDERSON, NATASHA ANN- MARIE (RN)
Entity type:Individual
Prefix:MISS
First Name:NATASHA
Middle Name:ANN- MARIE
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:988 E 106TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11236-3012
Mailing Address - Country:US
Mailing Address - Phone:561-317-8785
Mailing Address - Fax:
Practice Address - Street 1:988 E 106TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11236-3012
Practice Address - Country:US
Practice Address - Phone:561-317-8785
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-15
Last Update Date:2025-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY801586-01163WA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)