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Individual

MS. PATRICIA A MAHATHATH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PMHNP, FNP

Contact information

Practice address
1000 E CHERRY ST, TROY, MO 63379-1513
(636) 528-8551
Mailing address
1000 E CHERRY ST, TROY, MO 63379-1513
(636) 528-8551

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
2014036363
MO
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
2023153247
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1790189272
MO
05
ENROLLED
IL
Enumeration date
10/13/2014
Last updated
08/29/2025
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