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Individual

ATHINA PATRICK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN-CNP

Contact information

Practice address
4430 MISSOURI AVE, FORT LEONARD WOOD, MO 65473-9098
(573) 596-1600
Mailing address
4430 MISSOUR AVE, FT LEONARD WOOD, MO 65473
(573) 596-1600
(573) 329-0852

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
CNP021931
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
14361858
CAQH
OH
01
CNP021931
NP LICENSE NUMBER
OH
Enumeration date
10/25/2016
Last updated
08/18/2022
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