Provider Demographics
NPI:1548857295
Name:WALDROP, NATALIE
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:
Last Name:WALDROP
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:609 VIRGINIA AVE NE APT 3106
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30306-3782
Mailing Address - Country:US
Mailing Address - Phone:334-275-0541
Mailing Address - Fax:
Practice Address - Street 1:1365 CLIFTON RD NE BLDG C
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30322-4404
Practice Address - Country:US
Practice Address - Phone:404-778-3184
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-29
Last Update Date:2024-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPA.1690363A00000X
TXPA14169363A00000X
GA12206363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant