MEDICARE: NATALIE SMITH PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	0110005176	VA

General Provider Information

NPI Number	:	1134585961
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NATALIE SMITH PA

Provider Business Mailing Address
First Line	:	1504 SANTA ROSA RD
Second Line	:
City	:	HENRICO
State	:	VA
Zip	:	23229-5109
Country	:	US
Telephone Number	:	804-210-3103
Fax Number	:

Provider Business Practice Location Address
First Line	:	1504 SANTA ROSA RD
Second Line	:
City	:	HENRICO
State	:	VA
Zip	:	23229-5109
Country	:	US
Telephone Number	:	804-210-3103
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/08/2016
Last Update Date	:	04/08/2026

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Directions to “ NATALIE SMITH PA” Practice Location

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