Provider Demographics
NPI:1174544282
Name:ARENA, NATALIE J (PA-C)
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:J
Last Name:ARENA
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 1:1906 BLAKE AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:GLENWOOD SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:81601
Mailing Address - Country:US
Mailing Address - Phone:970-945-8683
Mailing Address - Fax:970-945-5843
Practice Address - Street 1:1906 BLAKE AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:GLENWOOD SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:81601
Practice Address - Country:US
Practice Address - Phone:970-945-8683
Practice Address - Fax:970-945-5843
Is Sole Proprietor?:No
Enumeration Date:2006-07-22
Last Update Date:2010-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2131363AM0700X
363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO95588353Medicaid
COC806822Medicare PIN
Q71774Medicare UPIN