Provider Demographics
NPI:1235578477
Name:MILLER, NATALIE DARLENE (PA-C)
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:DARLENE
Last Name:MILLER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
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Mailing Address - Street 1:4795 LARIMER PKWY STE 150
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:CO
Mailing Address - Zip Code:80534-9588
Mailing Address - Country:US
Mailing Address - Phone:970-342-2222
Mailing Address - Fax:970-342-2233
Practice Address - Street 1:2032 LOWE ST
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-5741
Practice Address - Country:US
Practice Address - Phone:970-342-2222
Practice Address - Fax:970-342-2233
Is Sole Proprietor?:No
Enumeration Date:2013-06-20
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
COPA0006021363AM0700X
WI4690-23363AM0700X
SC1110395363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical