Provider Demographics
NPI:1346042355
Name:PATTON, NICHOLE ALEXIS (APRN)
Entity type:Individual
Prefix:
First Name:NICHOLE
Middle Name:ALEXIS
Last Name:PATTON
Suffix:
Gender:
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5646 FAIRWAY RD
Mailing Address - Street 2:
Mailing Address - City:FAIRWAY
Mailing Address - State:KS
Mailing Address - Zip Code:66205-2642
Mailing Address - Country:US
Mailing Address - Phone:913-231-7066
Mailing Address - Fax:
Practice Address - Street 1:2921 SW WANAMAKER DR
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66614-5328
Practice Address - Country:US
Practice Address - Phone:785-272-6860
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-27
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-84196-041363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner