Provider Demographics
NPI:1811883259
Name:MCBRANCH, NATALIE ALICIA (PA-C)
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:ALICIA
Last Name:MCBRANCH
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1690 E 2000 S
Mailing Address - Street 2:
Mailing Address - City:DRIGGS
Mailing Address - State:ID
Mailing Address - Zip Code:83422-4896
Mailing Address - Country:US
Mailing Address - Phone:505-629-8582
Mailing Address - Fax:
Practice Address - Street 1:1690 E 2000 S
Practice Address - Street 2:
Practice Address - City:DRIGGS
Practice Address - State:ID
Practice Address - Zip Code:83422-4896
Practice Address - Country:US
Practice Address - Phone:505-629-8582
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-13
Last Update Date:2025-06-13
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant