Provider Demographics
NPI:1124344932
Name:PATTON FAMILY HEALTH CENTER PLLC
Entity type:Organization
Organization Name:PATTON FAMILY HEALTH CENTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:D
Authorized Official - Last Name:PATTON
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:319-643-3462
Mailing Address - Street 1:PO BOX 40
Mailing Address - Street 2:PATTON FAMILY HEALTH CENTER
Mailing Address - City:WEST BRANCH
Mailing Address - State:IA
Mailing Address - Zip Code:52358-0040
Mailing Address - Country:US
Mailing Address - Phone:319-643-3462
Mailing Address - Fax:316-643-3467
Practice Address - Street 1:116 N 1ST ST
Practice Address - Street 2:
Practice Address - City:WEST BRANCH
Practice Address - State:IA
Practice Address - Zip Code:52358-9663
Practice Address - Country:US
Practice Address - Phone:319-643-3462
Practice Address - Fax:319-643-3467
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-19
Last Update Date:2014-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA086807363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty