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General NPI Number Information
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NPI Number | 1609234871
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Entity Type | Individual
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Provider Name | DAWN SHONTELL PATRICK FNP
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Gender | Female
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Dates
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Enumeration Date | 02/03/2016
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Last Update Date | 06/06/2025
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Provider Practice Location Address
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Address Line | 199 N FLORISSANT RD
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City | FERGUSON
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State | MO
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Zip | 63135-1976
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Country | US
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Telephone | 314-449-9640
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Fax | 314-949-3437
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Provider Business Mailing Address
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Address Line | 102 WOODMONT BLVD STE 600
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City | NASHVILLE
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State | TN
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Zip | 37205-5250
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Country | US
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Telephone | 888-987-1151
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 2016001341
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License Number State | MO
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