Provider Demographics
NPI:1598148744
Name:INABNETT, NATALIE FORSBERG (PA-C)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:FORSBERG
Last Name:INABNETT
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:NATALIE
Other - Middle Name:
Other - Last Name:FORSBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2001 2ND AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29486-7887
Mailing Address - Country:US
Mailing Address - Phone:843-793-5182
Mailing Address - Fax:843-266-5125
Practice Address - Street 1:2001 2ND AVE STE 101
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29486-7887
Practice Address - Country:US
Practice Address - Phone:843-722-8000
Practice Address - Fax:843-647-6066
Is Sole Proprietor?:No
Enumeration Date:2015-07-07
Last Update Date:2020-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2359363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC2255PAMedicaid
SCSC6185Medicare PIN