Basic Information
| Provider Information | |||||||||
| NPI: | 1174583629 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HOMON | ||||||||
| FirstName: | PATRICIA | ||||||||
| MiddleName: | P | ||||||||
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| Credential: | ARNP2143102 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1815 S KANNER HWY | ||||||||
| Address2: | |||||||||
| City: | STAURT | ||||||||
| State: | FL | ||||||||
| PostalCode: | 34994 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7722882992 | ||||||||
| FaxNumber: | 7722882999 | ||||||||
| Practice Location | |||||||||
| Address1: | 1815 S KANNER HWY | ||||||||
| Address2: | |||||||||
| City: | STAURT | ||||||||
| State: | FL | ||||||||
| PostalCode: | 34994 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7722882992 | ||||||||
| FaxNumber: | 7722882999 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/27/2006 | ||||||||
| LastUpdateDate: | 02/27/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LX0001X | APRN2143102 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Obstetrics & Gynecology |
No ID Information.