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General NPI Number Information
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NPI Number | 1346936200
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Entity Type | Individual
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Provider Name | MONICA L PATRICK BSN, RN
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Gender | Female
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Dates
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Enumeration Date | 04/13/2023
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Last Update Date | 04/13/2023
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Provider Practice Location Address
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Address Line | 8207 22ND AVE
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City | KENOSHA
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State | WI
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Zip | 53143-6206
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Country | US
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Telephone | 731-313-6324
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Fax |
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Provider Business Mailing Address
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Address Line | 3213 KENSINGTON LN
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City | ZION
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State | IL
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Zip | 60099-4739
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Country | US
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Telephone | 731-313-6324
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WP2201X
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Taxonomy Name | Ambulatory Care Registered Nurse
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License Number | 041391360
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License Number State | IL
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