Provider Demographics
NPI:1194044495
Name:CONDE, NATALIE E (PA-C)
Entity type:Individual
Prefix:MS
First Name:NATALIE
Middle Name:E
Last Name:CONDE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MRS
Other - First Name:NATALIE
Other - Middle Name:E
Other - Last Name:CONDE-COLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:PO BOX 749306
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-9306
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2601 ROSEWOOD DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29205-3745
Practice Address - Country:US
Practice Address - Phone:803-782-4051
Practice Address - Fax:803-790-6612
Is Sole Proprietor?:No
Enumeration Date:2010-05-26
Last Update Date:2024-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-02035363A00000X
FLPA9105106363A00000X
SC4947363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant