Most Relevant Information
Provider Data
| NPI Number: | 1003426883 |
| Provider Name: | NATASHA L FENELON APRN |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | 11008419 |
Most Important Dates
| Enumeration Date: | 08/05/2020 |
| Last Updated: | 03/08/2022 |
Provider Practice Location
684 STATE ROAD 60 W
LAKE WALES
FL
338534419
Practice Location Phone/Fax
| Phone: | 8639494868 |
| Fax: | 8632238549 |
Provider Mailing Location
6675 WESTWOOD BLVD
STE 475
ORLANDO
FL
328216027
Provider Mailing Phone/Fax
| Phone: | 4078450330 |
| Fax: | 8889721752 |