Provider Demographics
NPI:1447490503
Name:KHUU, NATALIE ANN (PA-C)
Entity type:Individual
Prefix:MRS
First Name:NATALIE
Middle Name:ANN
Last Name:KHUU
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:NATALIE
Other - Middle Name:ANN
Other - Last Name:METCALF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:2380 W HORIZON RIDGE PKWY
Mailing Address - Street 2:SUITE 110
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-5078
Mailing Address - Country:US
Mailing Address - Phone:702-823-4255
Mailing Address - Fax:702-475-3261
Practice Address - Street 1:1500 S 48TH ST STE 508
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-1279
Practice Address - Country:US
Practice Address - Phone:402-483-2886
Practice Address - Fax:024-899-6844
Is Sole Proprietor?:No
Enumeration Date:2009-03-03
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVPA1152363A00000X
NV1702803811363AM0700X
NE2403363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVBP6872Medicare PIN