Provider Demographics
NPI:1922300623
Name:KORTIS, NATALIE JOY (PA)
Entity Type:Individual
Prefix:MRS
First Name:NATALIE
Middle Name:JOY
Last Name:KORTIS
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:1507 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:GATESVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76528-1024
Mailing Address - Country:US
Mailing Address - Phone:254-865-2166
Mailing Address - Fax:254-865-2141
Practice Address - Street 1:1507 W MAIN ST
Practice Address - Street 2:
Practice Address - City:GATESVILLE
Practice Address - State:TX
Practice Address - Zip Code:76528-1024
Practice Address - Country:US
Practice Address - Phone:254-865-2166
Practice Address - Fax:254-865-2141
Is Sole Proprietor?:No
Enumeration Date:2010-12-01
Last Update Date:2015-03-17
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant