Healthcare Provider Details

I. General information

NPI: 1124344932
Provider Name (Legal Business Name): PATTON FAMILY HEALTH CENTER PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/19/2010
Last Update Date: 05/01/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

116 N 1ST ST
WEST BRANCH IA
52358-9663
US

IV. Provider business mailing address

PO BOX 40 PATTON FAMILY HEALTH CENTER
WEST BRANCH IA
52358-0040
US

V. Phone/Fax

Practice location:
  • Phone: 319-643-3462
  • Fax: 319-643-3467
Mailing address:
  • Phone: 319-643-3462
  • Fax: 316-643-3467

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberA086807
License Number StateIA

VIII. Authorized Official

Name: EMILY D PATTON
Title or Position: CEO
Credential: ARNP
Phone: 319-643-3462