Doctor Name: | MRS. ANGELA MAE PATRICK |
NPI Number: | 1184906422 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | APRN |
License Number: | 111300 |
Business Practice Address: | 912 Central Ave Grant, NE - 691403099 |
Business Phone Number: | 3083527100 |
Business Fax Number: | 3083527290 |
Mailing Address: | 7 Parkway Ave, GRANT |
State: | NE |
Postal Code: | 691403205 |
Phone Number: | 3083522622 |
Fax Number: | |
NPI Enumeration Date: | 09/13/2011 |
NPI Last Update Date: | 11/26/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 111300 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NE |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |