Provider Demographics
NPI:1922087899
Name:WEBER, NATALIE MARIE (PA-C)
Entity Type:Individual
Prefix:MS
First Name:NATALIE
Middle Name:MARIE
Last Name:WEBER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:NATALIE
Other - Middle Name:MARIE
Other - Last Name:PILCHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:740 E OAK ST
Mailing Address - Street 2:
Mailing Address - City:MONTICELLO
Mailing Address - State:IA
Mailing Address - Zip Code:52310-1745
Mailing Address - Country:US
Mailing Address - Phone:319-465-6702
Mailing Address - Fax:
Practice Address - Street 1:740 E OAK ST
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:IA
Practice Address - Zip Code:52310-1745
Practice Address - Country:US
Practice Address - Phone:319-465-6702
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-10
Last Update Date:2014-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA001600363A00000X
WY443363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAPO00173616OtherRR MEDICARE
IAP01278236OtherRR MEDICARE
IAPO00173616OtherRR MEDICARE
IAI14278Medicare ID - Type Unspecified
IAQ31300Medicare UPIN
Q31300Medicare UPIN