Individual
JASON PATRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
2240 WINROW RD, FORT HUACHUCA, AZ 85613-5080
(520) 533-9200
Mailing address
2240 WINROW RD, FORT HUACHUCA, AZ 85613-5080
(520) 533-9200
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
242268
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
242268
FNP LICENSE
AZ
Enumeration date
06/19/2020
Last updated
12/06/2023
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