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NPI Code Detail

MEDICARE: PATRICIA KEHINDE DARE APRN, PMHNP-BC

MEDICARE: PATRICIA KEHINDE DARE APRN, PMHNP-BC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered NurseRN106769GA
2363LP0808XPsychiatric/Mental Health Nurse PractitionerRN106769GA

General Provider Information

NPI Number : 1043383607
Entity Type Code : Individual
Provider Name (Legal Business Name) : PATRICIA KEHINDE DARE APRN, PMHNP-BC
Provider Business Mailing Address
First Line : 7738 BAR HARBOR DR
Second Line :
City : RIVERDALE
State : GA
Zip : 30296-3357
Country : US
Telephone Number : 678-549-1070
Fax Number :
Provider Business Practice Location Address
First Line : 450 WINN WAY
Second Line :
City : DECATUR
State : GA
Zip : 30030-1715
Country : US
Telephone Number : 404-294-0499
Fax Number : 404-294-0793
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/15/2006
Last Update Date : 01/11/2022

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Directions to “ PATRICIA KEHINDE DARE APRN, PMHNP-BC” Practice Location

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