Provider Demographics
NPI:1689193609
Name:STANLEY, NATALIE (PA-C)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:
Last Name:STANLEY
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 1:11950 MACCORKLE AVE
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:WV
Mailing Address - Zip Code:25315-1135
Mailing Address - Country:US
Mailing Address - Phone:304-220-2111
Mailing Address - Fax:
Practice Address - Street 1:11950 MACCORKLE AVE
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:WV
Practice Address - Zip Code:25315-1135
Practice Address - Country:US
Practice Address - Phone:304-220-2111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-11
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant