Provider Demographics
NPI:1215919618
Name:ALDRICH, PATRICIA J (ARNP)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:J
Last Name:ALDRICH
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5880 UNIVERSITY AVE
Mailing Address - Street 2:SUITE 205
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-8220
Mailing Address - Country:US
Mailing Address - Phone:515-633-3835
Mailing Address - Fax:515-633-3837
Practice Address - Street 1:1816 PHILADELPHIA ST
Practice Address - Street 2:
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50010-8771
Practice Address - Country:US
Practice Address - Phone:515-232-2500
Practice Address - Fax:515-663-4131
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IAA049130363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1225870Medicaid
IA1225870Medicaid
IAP38483Medicare UPIN