Provider Demographics
NPI:1285772822
Name:GAGE, PATRICE (CNP)
Entity type:Individual
Prefix:
First Name:PATRICE
Middle Name:
Last Name:GAGE
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:24 FRANK LLOYD WRIGHT DR
Mailing Address - Street 2:PO BOX 0446 LOBBY J
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48105-9484
Mailing Address - Country:US
Mailing Address - Phone:734-747-6766
Mailing Address - Fax:734-222-3100
Practice Address - Street 1:2305 GENOA BUSINESS PARK DR
Practice Address - Street 2:STE 240
Practice Address - City:BRIGHTON
Practice Address - State:MI
Practice Address - Zip Code:48114-7004
Practice Address - Country:US
Practice Address - Phone:810-494-6820
Practice Address - Fax:810-229-0747
Is Sole Proprietor?:No
Enumeration Date:2007-02-04
Last Update Date:2014-05-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4704181120363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics