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NPI Code Detail

MEDICARE: NICOLE ANN PATRICK

MEDICARE: NICOLE ANN PATRICK
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
1363A00000XPhysician AssistantPA10004404WA
2363A00000XPhysician Assistant8182AZ
3363A00000XPhysician AssistantPA200002371DC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1299430OTHERINTERNAL ID-MOTOR VEHICLE ID
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1801986757
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICOLE ANN PATRICK
Provider Business Mailing Address
First Line : PO BOX 50095
Second Line :
City : SEATTLE
State : WA
Zip : 98145-5095
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2929 E THOMAS RD
Second Line :
City : PHOENIX
State : AZ
Zip : 85016-8034
Country : US
Telephone Number : 602-344-1317
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/13/2006
Last Update Date : 01/27/2026

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Directions to “ NICOLE ANN PATRICK ” Practice Location

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