Provider Demographics
NPI:1215211107
Name:PARKIN, NATALIE M (PAC)
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:M
Last Name:PARKIN
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:763 N REDWOOD RD
Mailing Address - Street 2:STE 110
Mailing Address - City:NORTH SALT LAKE
Mailing Address - State:UT
Mailing Address - Zip Code:84054-2895
Mailing Address - Country:US
Mailing Address - Phone:801-298-3812
Mailing Address - Fax:877-450-7813
Practice Address - Street 1:425 MEDICAL DR STE 205
Practice Address - Street 2:
Practice Address - City:BOUNTIFUL
Practice Address - State:UT
Practice Address - Zip Code:84010-4953
Practice Address - Country:US
Practice Address - Phone:801-298-3812
Practice Address - Fax:877-450-7813
Is Sole Proprietor?:No
Enumeration Date:2011-10-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
UT8093914-1206363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant