Provider Demographics
NPI:1528134681
Name:WYSS, PATRICIA ANNE (FNP)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:ANNE
Last Name:WYSS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3579 FRAKLIN BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97403
Mailing Address - Country:US
Mailing Address - Phone:541-520-4647
Mailing Address - Fax:
Practice Address - Street 1:3579 FRANKLIN BOULEVARD
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97403
Practice Address - Country:US
Practice Address - Phone:541-344-9411
Practice Address - Fax:541-344-6519
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2013-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR200150102NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR000283Medicaid