Basic Information
| Provider Information | |||||||||
| NPI: | 1710985700 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CASE | ||||||||
| FirstName: | PATRICIA | ||||||||
| MiddleName: | E | ||||||||
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| Credential: | DNP APRN CNM | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8110 ROYAL PALM BLVD STE 108 | ||||||||
| Address2: | |||||||||
| City: | CORAL SPRINGS | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330655742 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9543418288 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2580 SAINT ROSE PKWY STE 140 | ||||||||
| Address2: | |||||||||
| City: | HENDERSON | ||||||||
| State: | NV | ||||||||
| PostalCode: | 890747792 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7028628862 | ||||||||
| FaxNumber: | 7028628774 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/13/2005 | ||||||||
| LastUpdateDate: | 01/04/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/13/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | APRN002237 | NV | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 367A00000X | APRN9173130 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Advanced Practice Midwife |
ID Information
| ID | Type | State | Issuer | Description | 1710985700 | 05 | NV | MEDICAID |