Provider Demographics
NPI:1891276572
Name:WEBER, NATALYA LORAIN (PA-C)
Entity Type:Individual
Prefix:MS
First Name:NATALYA
Middle Name:LORAIN
Last Name:WEBER
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 1:65717 COUNTY ROAD AA
Mailing Address - Street 2:
Mailing Address - City:SHERIDAN LAKE
Mailing Address - State:CO
Mailing Address - Zip Code:81071-9733
Mailing Address - Country:US
Mailing Address - Phone:719-691-5245
Mailing Address - Fax:
Practice Address - Street 1:211 E EARL ST
Practice Address - Street 2:
Practice Address - City:LEOTI
Practice Address - State:KS
Practice Address - Zip Code:67861-9620
Practice Address - Country:US
Practice Address - Phone:620-375-2233
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-22
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant