Provider Demographics
NPI:1073536512
Name:WOODARD, NATALIE B (PA-C)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:B
Last Name:WOODARD
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 309
Mailing Address - Street 2:
Mailing Address - City:AULANDER
Mailing Address - State:NC
Mailing Address - Zip Code:27805-0309
Mailing Address - Country:US
Mailing Address - Phone:252-345-3791
Mailing Address - Fax:252-345-0480
Practice Address - Street 1:600 S CHURCH ST
Practice Address - Street 2:
Practice Address - City:HERTFORD
Practice Address - State:NC
Practice Address - Zip Code:27944-1205
Practice Address - Country:US
Practice Address - Phone:252-426-5711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2022-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC103288363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2753281Medicare ID - Type Unspecified
NCP40146Medicare UPIN