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NPI Code Detail

MEDICARE: PATRICIA MENCEL APRN

MEDICARE: PATRICIA MENCEL APRN
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 Practitioner001852CT
2363L00000XNurse Practitioner5009719NC

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P000057594OTHERCTRAILROAD MEDICARE

Other Identifiers

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

General Provider Information

NPI Number : 1891768115
Entity Type Code : Individual
Provider Name (Legal Business Name) : PATRICIA MENCEL APRN
Provider Business Mailing Address
First Line : 30 W MONROE ST STE 1200
Second Line :
City : CHICAGO
State : IL
Zip : 60603-2420
Country : US
Telephone Number : 312-733-9730
Fax Number : 773-866-8014
Provider Business Practice Location Address
First Line : 3250 FREEDOM DR
Second Line :
City : CHARLOTTE
State : NC
Zip : 28208-2817
Country : US
Telephone Number : 704-709-6009
Fax Number : 704-899-0470
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/08/2006
Last Update Date : 03/13/2020

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Directions to “ PATRICIA MENCEL APRN” Practice Location

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