Provider Demographics
NPI:1831349471
Name:MILLER, NATALIE SARAH (PAC)
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:SARAH
Last Name:MILLER
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:NATALIE
Other - Middle Name:SARAH
Other - Last Name:DILLON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6324 FAIRVIEW RD STE 201
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28210-4278
Practice Address - Country:US
Practice Address - Phone:704-384-0588
Practice Address - Fax:704-384-0580
Is Sole Proprietor?:No
Enumeration Date:2008-09-19
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDT0003841363A00000X
NC0010-12339363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant