MEDICARE: MS. BARBARA JANE PATTERSON ARNP

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
1	363LF0000X	Family Nurse Practitioner	9173894NP	FL

General Provider Information

NPI Number	:	1760698104
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. BARBARA JANE PATTERSON ARNP

Provider Business Mailing Address
First Line	:	733 CUSTWOOD DRIVE
Second Line	:
City	:	ST AUGUSTINE
State	:	FL
Zip	:	32086
Country	:	US
Telephone Number	:	904-234-5322
Fax Number	:	904-797-7684

Provider Business Practice Location Address
First Line	:	1093 A1A BEACH BLVD
Second Line	:	#109 ANASTASIA PLAZA
City	:	ST AUGUSTINE BEACH
State	:	FL
Zip	:	32080-6733
Country	:	US
Telephone Number	:	904-234-5322
Fax Number	:	904-234-5322

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/15/2007
Last Update Date	:	07/08/2007

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