Provider Demographics
NPI:1063642296
Name:MOSELEY, NATALIE KESSLER (PA)
Entity type:Individual
Prefix:MRS
First Name:NATALIE
Middle Name:KESSLER
Last Name:MOSELEY
Suffix:
Gender:F
Credentials:PA
Other - Prefix:MISS
Other - First Name:NATALIE
Other - Middle Name:MORGAN
Other - Last Name:KESSLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1010 PRINCE AVE
Mailing Address - Street 2:SUITE 115 SOUTH
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30606-5805
Mailing Address - Country:US
Mailing Address - Phone:706-583-9000
Mailing Address - Fax:706-353-6525
Practice Address - Street 1:2061 EXPERIMENT STATION RD STE 505
Practice Address - Street 2:
Practice Address - City:WATKINSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30677-5327
Practice Address - Country:US
Practice Address - Phone:706-310-0324
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-22
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA5645363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant