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NPI Code Detail

MEDICARE: KIM PATRICK

MEDICARE: KIM PATRICK
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1588598262
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIM PATRICK
Provider Business Mailing Address
First Line : 1442 SKYGROVE PL NW
Second Line :
City : CONCORD
State : NC
Zip : 28027-8339
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1777 OLD EARNHARDT RD
Second Line :
City : KANNAPOLIS
State : NC
Zip : 28083-8023
Country : US
Telephone Number : 615-560-6622
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/09/2026
Last Update Date : 06/09/2026

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Directions to “ KIM PATRICK ” Practice Location

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