Provider Demographics
NPI:1285226324
Name:ANDRESKY, NATALIE EVE (PA-C)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:EVE
Last Name:ANDRESKY
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 1:130 STONEGATE DR
Mailing Address - Street 2:
Mailing Address - City:MC MURRAY
Mailing Address - State:PA
Mailing Address - Zip Code:15317-2765
Mailing Address - Country:US
Mailing Address - Phone:181-474-6610
Mailing Address - Fax:
Practice Address - Street 1:1225 WARM SPRINGS AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGDON
Practice Address - State:PA
Practice Address - Zip Code:16652-2350
Practice Address - Country:US
Practice Address - Phone:814-746-6106
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-10
Last Update Date:2021-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA062230363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant