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NPI Code Detail

MEDICARE: NATALIE GRACE GATES

MEDICARE: NATALIE GRACE GATES
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
1363A00000XPhysician Assistant0010-16222NC

General Provider Information

NPI Number : 1730998352
Entity Type Code : Individual
Provider Name (Legal Business Name) : NATALIE GRACE GATES
Provider Business Mailing Address
First Line : PO BOX 60447
Second Line :
City : CHARLOTTE
State : NC
Zip : 28260-0447
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 200 HAWTHORNE LN
Second Line :
City : CHARLOTTE
State : NC
Zip : 28204-2515
Country : US
Telephone Number : 704-384-9437
Fax Number : 704-384-9440
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/07/2025
Last Update Date : 03/25/2026

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