Provider Demographics
NPI:1134585961
Name:SMITH, NATALIE (PA)
Entity type:Individual
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First Name:NATALIE
Middle Name:
Last Name:SMITH
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Gender:F
Credentials:PA
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Mailing Address - Street 1:183 SPOTNAP RD STE C
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22911-8812
Mailing Address - Country:US
Mailing Address - Phone:434-244-8412
Mailing Address - Fax:434-244-8415
Practice Address - Street 1:183 SPOTNAP RD STE C
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22911-8812
Practice Address - Country:US
Practice Address - Phone:434-244-8412
Practice Address - Fax:434-244-8415
Is Sole Proprietor?:No
Enumeration Date:2016-01-08
Last Update Date:2020-05-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0110005176363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant