Provider Demographics
NPI:1528101789
Name:LILLQUIST, PATRICIA ANN (MD)
Entity type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:ANN
Last Name:LILLQUIST
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:BUILDING 4389
Mailing Address - Street 2:BEAUFORT ROAD
Mailing Address - City:CHERRY POINT
Mailing Address - State:NC
Mailing Address - Zip Code:28533
Mailing Address - Country:US
Mailing Address - Phone:252-466-0266
Mailing Address - Fax:252-466-0237
Practice Address - Street 1:BLDG 4389
Practice Address - Street 2:BEAUFORT ROAD
Practice Address - City:CHERRY POINT
Practice Address - State:NC
Practice Address - Zip Code:28533
Practice Address - Country:US
Practice Address - Phone:252-466-0266
Practice Address - Fax:252-466-0237
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2021-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1527282084P0800X
NC2009-007912084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5912177Medicaid
NC5912177Medicaid