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General NPI Number Information
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NPI Number | 1770836967
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Entity Type | Individual
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Provider Name | PATRICK BRENDLE MCEVOY MSW
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Gender | Male
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Dates
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Enumeration Date | 10/25/2012
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Last Update Date | 04/18/2024
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Provider Practice Location Address
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Address Line | 2117 CAMPUS DR SE
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City | ROCHESTER
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State | MN
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Zip | 55904-4800
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Country | US
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Telephone | 507-328-6256
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Fax | 507-328-6263
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Provider Business Mailing Address
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Address Line | 2117 CAMPUS DR SE
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City | ROCHESTER
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State | MN
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Zip | 55904-4800
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Country | US
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Telephone | 507-328-6256
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Fax | 507-328-6263
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 11982
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License Number State | MN
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