Provider Demographics
NPI:1366570525
Name:PATRICK, CHRISTINE E (ARNP)
Entity type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:E
Last Name:PATRICK
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3576 FAIRWAY FOREST DR
Mailing Address - Street 2:
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34685-1005
Mailing Address - Country:US
Mailing Address - Phone:813-988-2700
Mailing Address - Fax:
Practice Address - Street 1:10801 N 56TH ST
Practice Address - Street 2:
Practice Address - City:TEMPLE TERRACE
Practice Address - State:FL
Practice Address - Zip Code:33617-3646
Practice Address - Country:US
Practice Address - Phone:813-988-2700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-01
Last Update Date:2015-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9243954363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner