Provider Demographics
NPI:1740155159
Name:MARLATT, PATRICK KENT
Entity type:Individual
Prefix:
First Name:PATRICK
Middle Name:KENT
Last Name:MARLATT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58175 PWF RD
Mailing Address - Street 2:
Mailing Address - City:DILLER
Mailing Address - State:NE
Mailing Address - Zip Code:68342-4039
Mailing Address - Country:US
Mailing Address - Phone:402-239-1580
Mailing Address - Fax:
Practice Address - Street 1:58175 PWF RD
Practice Address - Street 2:
Practice Address - City:DILLER
Practice Address - State:NE
Practice Address - Zip Code:68342-4039
Practice Address - Country:US
Practice Address - Phone:402-239-1580
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-07
Last Update Date:2025-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE373H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist