Provider Demographics
NPI:1508295973
Name:OREY, NATALIE E (PA-C)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:E
Last Name:OREY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:NATALIE
Other - Middle Name:E
Other - Last Name:KNUTH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:PO BOX 184
Mailing Address - Street 2:
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49443-0184
Mailing Address - Country:US
Mailing Address - Phone:231-672-8700
Mailing Address - Fax:231-728-1675
Practice Address - Street 1:1675 LEAHY ST STE 324B
Practice Address - Street 2:
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49442-5500
Practice Address - Country:US
Practice Address - Phone:231-672-2120
Practice Address - Fax:231-728-1675
Is Sole Proprietor?:No
Enumeration Date:2013-11-06
Last Update Date:2021-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5601006872363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIMI1763068OtherMEDICARE PTAN