1346435229 NPI number — PATRICIA ANN FIELDS PMHNP APRN

Table of content: PATRICIA ANN FIELDS PMHNP APRN (NPI 1346435229)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346435229 NPI number — PATRICIA ANN FIELDS PMHNP APRN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FIELDS
Provider First Name:
PATRICIA
Provider Middle Name:
ANN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PMHNP APRN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
FIELDS
Provider Other First Name:
PATRICIA
Provider Other Middle Name:
ANN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
APRN
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1346435229
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/30/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
301 HENRY ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NORTH VERNON
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
47265-1030
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
812-883-6779
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
301 HENRY ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORTH VERNON
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
47265-1030
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
812-883-6779
Provider Business Practice Location Address Fax Number:
812-352-2420
Provider Enumeration Date:
09/13/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LP0808X , with the licence number:  71011532A , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 163WP0808X , with the licence number: 28160542A , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 28160542A . This is a "RN LICENSE" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".




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