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Individual
PATRICE MCMOON
Active
Individual
PATRICE MCMOON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
0110009009
VA
363A00000X
Physician Assistant
0110009009
VA
363A00000X
Physician Assistant
Primary
57069
CA
363AM0700X
Medical Physician Assistant
PA.0003501
CO
363AM0700X
Medical Physician Assistant
PA0003501
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1366630519
NPI
—
05
—
1366630519
—
NV
Enumeration date
10/11/2007
Last updated
08/09/2024
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