Provider Demographics
NPI:1578040614
Name:HOWARD, NATALIE MOORE (MD)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:MOORE
Last Name:HOWARD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:NATALIE
Other - Middle Name:
Other - Last Name:KOSKO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2301 HOUSE AVE STE 400
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82001-3180
Mailing Address - Country:US
Mailing Address - Phone:307-634-5216
Mailing Address - Fax:
Practice Address - Street 1:2301 HOUSE AVE STE 400
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82001-3180
Practice Address - Country:US
Practice Address - Phone:307-634-5216
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-22
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE8368207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE8368Medicaid
WY14954AOtherSTATE MEDICAL LICENSE