Healthcare Provider Details
I. General information
NPI: 1710985700
Provider Name (Legal Business Name): PATRICIA E CASE DNP APRN CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/13/2005
Last Update Date: 10/25/2024
Certification Date: 10/25/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1733 LAKELAND HILLS BLVD
LAKELAND FL
33805-3016
US
IV. Provider business mailing address
PO BOX 748817
ATLANTA GA
30374-8817
US
V. Phone/Fax
- Phone: 863-688-1528
- Fax: 863-688-8423
- Phone: 813-286-0033
- Fax: 813-282-1806
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | APRN002237 |
| License Number State | NV |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 367A00000X |
| Taxonomy | Advanced Practice Midwife |
| License Number | APRN9173130 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: