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Individual
NATHAN KENNETH COLEBANK
Active
Individual
NATHAN KENNETH COLEBANK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
C08156
MD
363A00000X
Physician Assistant
—
—
363AS0400X
Surgical Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1185755
NCCPA
—
01
—
C08156
STATE LICENSE
MD
Enumeration date
06/29/2021
Last updated
01/04/2024
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