Provider Demographics
NPI:1053658237
Name:SEIBERT, NATALIE L (PA)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:L
Last Name:SEIBERT
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:NATALIE
Other - Middle Name:L
Other - Last Name:ST. LOUIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:515 22ND AVE
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:WI
Mailing Address - Zip Code:53566-1569
Mailing Address - Country:US
Mailing Address - Phone:405-749-7099
Mailing Address - Fax:405-341-3795
Practice Address - Street 1:515 22ND AVE
Practice Address - Street 2:MONROE CLINIC
Practice Address - City:MONROE
Practice Address - State:WI
Practice Address - Zip Code:53566-1569
Practice Address - Country:US
Practice Address - Phone:608-324-2222
Practice Address - Fax:405-341-3795
Is Sole Proprietor?:No
Enumeration Date:2013-01-09
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1598363AM0700X
363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical