Provider Demographics
NPI:1104171529
Name:HESS, PATRICIA A (NP)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:A
Last Name:HESS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:A
Other - Last Name:HESS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:109 E ELM ST
Mailing Address - Street 2:
Mailing Address - City:STREATOR
Mailing Address - State:IL
Mailing Address - Zip Code:61364-2223
Mailing Address - Country:US
Mailing Address - Phone:815-672-4587
Mailing Address - Fax:815-673-3582
Practice Address - Street 1:109 E ELM ST
Practice Address - Street 2:
Practice Address - City:STREATOR
Practice Address - State:IL
Practice Address - Zip Code:61364-2223
Practice Address - Country:US
Practice Address - Phone:815-672-4587
Practice Address - Fax:815-673-3582
Is Sole Proprietor?:No
Enumeration Date:2012-07-23
Last Update Date:2012-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209009580363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily