Provider Demographics
NPI:1912537374
Name:MILLER, NATALIE MARIE (PA-C)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:MARIE
Last Name:MILLER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:NATALIE
Other - Middle Name:MARIE
Other - Last Name:CASSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:1950 DARREN DR
Mailing Address - Street 2:
Mailing Address - City:KINGMAN
Mailing Address - State:AZ
Mailing Address - Zip Code:86401-5014
Mailing Address - Country:US
Mailing Address - Phone:928-279-2560
Mailing Address - Fax:
Practice Address - Street 1:US NAVAL HOSPITAL OKINAWA
Practice Address - Street 2:
Practice Address - City:CHATAN
Practice Address - State:NAKAGAMI DISTRICT
Practice Address - Zip Code:9040103
Practice Address - Country:JP
Practice Address - Phone:098-971-9355
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant