Provider Demographics
NPI:1699215111
Name:PEMBERTON, NATALIE BRIM (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:NATALIE
Middle Name:BRIM
Last Name:PEMBERTON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:NATALIE
Other - Middle Name:CHRISTINE
Other - Last Name:BRIM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:1001 BLYTHE BLVD.
Mailing Address - Street 2:MEDICAL CENTER PLAZA, STE 200
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28203
Mailing Address - Country:US
Mailing Address - Phone:704-381-4820
Mailing Address - Fax:
Practice Address - Street 1:1001 BLYTHE BLVD.
Practice Address - Street 2:MEDICAL CENTER PLAZA, STE 200
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28203-5865
Practice Address - Country:US
Practice Address - Phone:704-381-4820
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-02
Last Update Date:2022-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant