MEDICARE: ANDREW W PATRICK APN

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	363L00000X	Nurse Practitioner	APN001050	NV

General Provider Information

NPI Number	:	1932369337
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREW W PATRICK APN

Provider Business Mailing Address
First Line	:	6935-104 ALIANTE PARKWAY
Second Line	:	SUITE 509
City	:	N. LAS VEGAS
State	:	NV
Zip	:	89084
Country	:	US
Telephone Number	:	702-518-8831
Fax Number	:	702-675-7789

Provider Business Practice Location Address
First Line	:	7495 W AZURE DR STE 232
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89130-4437
Country	:	US
Telephone Number	:	702-518-8831
Fax Number	:

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

Provider Enumeration Date	:	06/10/2008
Last Update Date	:	07/21/2022

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