MEDICARE: PATRICIA ALDEN FLATEAU CPNP-AC

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
1	363LP0200X	Pediatric Nurse Practitioner	662493	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1811098627
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICIA ALDEN FLATEAU CPNP-AC

Provider Business Mailing Address
First Line	:	5015 ADDISON CIR
Second Line	:	#428
City	:	ADDISON
State	:	TX
Zip	:	75001-3308
Country	:	US
Telephone Number	:	214-529-7318
Fax Number	:

Provider Business Practice Location Address
First Line	:	5015 ADDISON CIR
Second Line	:	#428
City	:	ADDISON
State	:	TX
Zip	:	75001-3308
Country	:	US
Telephone Number	:	214-529-7318
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/26/2006
Last Update Date	:	09/02/2011

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