Individual
MS. NATALIE GREVELINK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1526 UTE BLVD STE 104, PARK CITY, UT 84098-7575
(435) 602-1918
(435) 731-8109
Mailing address
1526 UTE BLVD STE 104, PARK CITY, UT 84098-7575
(435) 602-1918
(435) 731-8109
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
12779730-1206
UT
363AM0700X
Medical Physician Assistant
AP1948
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12779750-1206
STATE LICENSE
UT
Enumeration date
05/10/2007
Last updated
08/07/2023
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