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General NPI Number Information
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NPI Number | 1760704340
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Entity Type | Organization
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Legal Business Name | PATTON FAMILY HEALTH CENTER
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Dates
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Enumeration Date | 02/23/2010
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Last Update Date | 02/23/2010
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Provider Practice Location Address
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Address Line | 116 NORTH 1ST STREET
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City | WEST BRANCH
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State | IA
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Zip | 52358
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Country | US
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Telephone | 319-643-3462
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Fax | 319-643-3467
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Provider Business Mailing Address
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Address Line | PO BOX 1377
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City | WATERLOO
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State | IA
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Zip | 50704-1377
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Country | US
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Telephone | 319-233-3044
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Fax | 319-233-0722
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Authorized Official
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Title or Position | OWNER
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Name | EMILY D PATTON
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Credential | ARNP
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Telephone | 319-233-3044
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | A086807
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License Number State | IA
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