Provider Demographics
NPI:1366889586
Name:PANTIN, PATRICE S (CRNA)
Entity type:Individual
Prefix:
First Name:PATRICE
Middle Name:S
Last Name:PANTIN
Suffix:
Gender:
Credentials:CRNA
Other - Prefix:
Other - First Name:PATRICE
Other - Middle Name:SHENTON
Other - Last Name:PANTIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CRNA
Mailing Address - Street 1:10313 MEDICIS PL
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33449-8069
Mailing Address - Country:US
Mailing Address - Phone:561-584-8569
Mailing Address - Fax:
Practice Address - Street 1:232 W 25TH ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16544-3300
Practice Address - Country:US
Practice Address - Phone:814-450-5000
Practice Address - Fax:814-452-7818
Is Sole Proprietor?:No
Enumeration Date:2013-05-29
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN754775367500000X
FLARNP9291949367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered