Provider Demographics
NPI:1871059998
Name:BOVINO, NATALIE ELIZABETH
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:ELIZABETH
Last Name:BOVINO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:888 RAVEN ROCK DR
Mailing Address - Street 2:
Mailing Address - City:BOONE
Mailing Address - State:NC
Mailing Address - Zip Code:28607-5115
Mailing Address - Country:US
Mailing Address - Phone:828-434-3479
Mailing Address - Fax:754-218-0891
Practice Address - Street 1:888 RAVEN ROCK DR
Practice Address - Street 2:
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607-5115
Practice Address - Country:US
Practice Address - Phone:828-434-3479
Practice Address - Fax:754-218-0891
Is Sole Proprietor?:No
Enumeration Date:2019-02-13
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5011469363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily