Provider Demographics
NPI:1487212304
Name:PATTON, NICHOLA ANTOINETTE (DNP, MBA, MSN AGACNP)
Entity type:Individual
Prefix:DR
First Name:NICHOLA
Middle Name:ANTOINETTE
Last Name:PATTON
Suffix:
Gender:F
Credentials:DNP, MBA, MSN AGACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2870 PEACHTREE RD NW # 915-6767
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30305-2918
Mailing Address - Country:US
Mailing Address - Phone:347-422-7329
Mailing Address - Fax:
Practice Address - Street 1:1309 COFFEEN AVE STE 12846
Practice Address - Street 2:
Practice Address - City:SHERIDAN
Practice Address - State:WY
Practice Address - Zip Code:82801-5777
Practice Address - Country:US
Practice Address - Phone:347-422-7329
Practice Address - Fax:866-782-6597
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-05
Last Update Date:2025-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO010174C363L00000X
NC5017749363L00000X
VA0024190991363L00000X
MDAC005119363L00000X
NY432981363L00000X
AZ309091363L00000X
NM80129363L00000X
FL2530363L00000X
ND200630363L00000X
UT14082107-4405363L00000X
ID5161577363L00000X
KS3383482112363L00000X
IAH181233363L00000X
VT101.0136900363LA2100X
WY53749363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner