Basic Information
| Provider Information | |||||||||
| NPI: | 1881984516 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FLATT | ||||||||
| FirstName: | PATRICIA | ||||||||
| MiddleName: | A | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | RN | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 155 | ||||||||
| Address2: | |||||||||
| City: | CHRISTOPHER | ||||||||
| State: | IL | ||||||||
| PostalCode: | 628220155 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6187242436 | ||||||||
| FaxNumber: | 6187242571 | ||||||||
| Practice Location | |||||||||
| Address1: | 6294 STATE HIGHWAY 154 | ||||||||
| Address2: | |||||||||
| City: | SESSER | ||||||||
| State: | IL | ||||||||
| PostalCode: | 628842163 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6186256679 | ||||||||
| FaxNumber: | 6186255362 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/14/2011 | ||||||||
| LastUpdateDate: | 04/14/2011 | ||||||||
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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 | 163W00000X | 041263649 | IL | Y | Nursing Service Providers | Registered Nurse |
No ID Information.