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NPI Code Detail

MEDICARE: DR. NICHOLA ANTOINETTE PATTON DNP, MBA, AGACNP-BC

MEDICARE: DR. NICHOLA ANTOINETTE PATTON DNP, MBA, AGACNP-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
1363L00000XNurse Practitioner432981NY
2363L00000XNurse PractitionerAC005119MD
3363L00000XNurse Practitioner309091AZ
4363L00000XNurse Practitioner5161577ID
5363L00000XNurse Practitioner200630ND
6363LA2100XAcute Care Nurse Practitioner101.0136900VT
7363L00000XNurse Practitioner3383482112KS
8363L00000XNurse Practitioner2530FL
9363L00000XNurse Practitioner0024190991VA
10363L00000XNurse Practitioner80129NM
11363L00000XNurse PractitionerH181233IA
12363L00000XNurse Practitioner5017749NC
13363LA2100XAcute Care Nurse Practitioner53749WY
14363L00000XNurse Practitioner010174CCO
15363L00000XNurse Practitioner14082107-4405UT

General Provider Information

NPI Number : 1487212304
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. NICHOLA ANTOINETTE PATTON DNP, MBA, AGACNP-BC
Provider Business Mailing Address
First Line : 1309 COFFEEN AVE STE 12846
Second Line :
City : SHERIDAN
State : WY
Zip : 82801-5777
Country : US
Telephone Number : 888-603-8008
Fax Number : 866-782-6597
Provider Business Practice Location Address
First Line : 1309 COFFEEN AVE STE 12846
Second Line :
City : SHERIDAN
State : WY
Zip : 82801-5777
Country : US
Telephone Number : 888-603-8008
Fax Number : 866-782-6597
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/05/2019
Last Update Date : 09/03/2025

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