Provider Demographics
NPI:1639496987
Name:MOSLEY, NATALIE MARIE (DO)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:MARIE
Last Name:MOSLEY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 560825
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80256-0825
Mailing Address - Country:US
Mailing Address - Phone:719-595-5980
Mailing Address - Fax:719-595-7417
Practice Address - Street 1:3676 PARKER BLVD.
Practice Address - Street 2:SUITE 280
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81008-2214
Practice Address - Country:US
Practice Address - Phone:719-595-8505
Practice Address - Fax:719-595-8509
Is Sole Proprietor?:No
Enumeration Date:2010-04-27
Last Update Date:2019-03-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CODR.0055366207P00000X, 208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO1639496987Medicaid