Provider Demographics
NPI:1275519415
Name:AUSTIN, NATALIE D (PA-C)
Entity type:Individual
Prefix:MRS
First Name:NATALIE
Middle Name:D
Last Name:AUSTIN
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:MRS
Other - First Name:NATALIE
Other - Middle Name:D
Other - Last Name:WHITE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:99 SELDOM SEEN RD
Mailing Address - Street 2:
Mailing Address - City:BRADFORDWOODS
Mailing Address - State:PA
Mailing Address - Zip Code:15015-1321
Mailing Address - Country:US
Mailing Address - Phone:412-974-7355
Mailing Address - Fax:888-803-3331
Practice Address - Street 1:2418 E YORK ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19125-3006
Practice Address - Country:US
Practice Address - Phone:888-803-3370
Practice Address - Fax:888-803-3331
Is Sole Proprietor?:No
Enumeration Date:2005-12-20
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50.003094363A00000X
CA62864363AM0700X
PAMA002767-L363A00000X
MI5601010527363AM0700X
NY028054363AM0700X
WV2502363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
S89715Medicare UPIN
OHAUPA37201Medicare PIN
PA077538JEDMedicare PIN