Provider Demographics
NPI:1679139745
Name:DEPEINE, NATACHA (APRN)
Entity type:Individual
Prefix:
First Name:NATACHA
Middle Name:
Last Name:DEPEINE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10914 OAK BEND WAY
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-6177
Mailing Address - Country:US
Mailing Address - Phone:561-574-1466
Mailing Address - Fax:
Practice Address - Street 1:3537 FOREST HILL BLVD STE B
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33406-5867
Practice Address - Country:US
Practice Address - Phone:561-892-6002
Practice Address - Fax:561-892-6001
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-14
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11002416363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care