Provider Demographics
NPI:1902491137
Name:ACEVEDO, NATALIE GISELLE (NP)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:GISELLE
Last Name:ACEVEDO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:NATALIE
Other - Middle Name:GISELLE
Other - Last Name:ACEVEDO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NP
Mailing Address - Street 1:16620 N US HIGHWAY 281 STE 300
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232-2679
Mailing Address - Country:US
Mailing Address - Phone:210-309-2405
Mailing Address - Fax:
Practice Address - Street 1:16620 N US HIGHWAY 281 STE 300
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232-2679
Practice Address - Country:US
Practice Address - Phone:210-309-2405
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-09
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF01211281363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily