Provider Demographics
NPI:1043466865
Name:WOLINSKI, NATASHA BRIANNE (PA-C)
Entity Type:Individual
Prefix:MS
First Name:NATASHA
Middle Name:BRIANNE
Last Name:WOLINSKI
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3205 N ACADEMY BLVD STE 130
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80917-5152
Mailing Address - Country:US
Mailing Address - Phone:719-632-5700
Mailing Address - Fax:719-344-7187
Practice Address - Street 1:12050 FALCON HWY
Practice Address - Street 2:
Practice Address - City:PEYTON
Practice Address - State:CO
Practice Address - Zip Code:80831-8076
Practice Address - Country:US
Practice Address - Phone:719-632-5700
Practice Address - Fax:719-344-7817
Is Sole Proprietor?:No
Enumeration Date:2008-08-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2631363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO45936021Medicaid