Provider Demographics
NPI:1023474483
Name:COON, NATALIE B (PA-C)
Entity type:Individual
Prefix:MRS
First Name:NATALIE
Middle Name:B
Last Name:COON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:NATALIE
Other - Middle Name:B
Other - Last Name:LONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:6238 MORROW RD
Mailing Address - Street 2:
Mailing Address - City:CELINA
Mailing Address - State:OH
Mailing Address - Zip Code:45822-9360
Mailing Address - Country:US
Mailing Address - Phone:410-916-2579
Mailing Address - Fax:
Practice Address - Street 1:1003 BELLEFONTAINE AVE
Practice Address - Street 2:SUITE 125
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45804
Practice Address - Country:US
Practice Address - Phone:419-998-8207
Practice Address - Fax:419-998-8216
Is Sole Proprietor?:No
Enumeration Date:2016-01-14
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50.004636363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant