Provider Demographics
NPI:1669773610
Name:ROSSER, NATASHA WRIGHT (PA-C)
Entity type:Individual
Prefix:MRS
First Name:NATASHA
Middle Name:WRIGHT
Last Name:ROSSER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 MEADOWMONT VILLAGE CIR STE 202
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27517-7518
Mailing Address - Country:US
Mailing Address - Phone:984-974-2950
Mailing Address - Fax:
Practice Address - Street 1:300 MEADOWMONT VILLAGE CIR STE 202
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27517-7518
Practice Address - Country:US
Practice Address - Phone:984-974-2950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-08
Last Update Date:2020-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-02601363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCNCU841AOtherMEDICARE PTAN