Basic Information
| Provider Information | |||||||||
| NPI: | 1720312051 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LUBRANO | ||||||||
| FirstName: | NATASHA | ||||||||
| MiddleName: | HICKS | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 230 PROSPECT PL STE 340B | ||||||||
| Address2: | |||||||||
| City: | CORONADO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 921181991 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6195224000 | ||||||||
| FaxNumber: | 6194350150 | ||||||||
| Practice Location | |||||||||
| Address1: | 230 PROSPECT PL | ||||||||
| Address2: | 340B | ||||||||
| City: | CORONADO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 921181978 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6195224000 | ||||||||
| FaxNumber: | 6194350150 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/18/2009 | ||||||||
| LastUpdateDate: | 12/13/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 19027 | CA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.