Provider Demographics
NPI:1003818675
Name:ESTEP, PATRICIA J (CFNP)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:J
Last Name:ESTEP
Suffix:
Gender:F
Credentials:CFNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1506 W GARFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:BARTONVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:61607-1755
Mailing Address - Country:US
Mailing Address - Phone:309-697-8416
Mailing Address - Fax:309-697-2749
Practice Address - Street 1:1506 W GARFIELD AVE
Practice Address - Street 2:
Practice Address - City:BARTONVILLE
Practice Address - State:IL
Practice Address - Zip Code:61607-1755
Practice Address - Country:US
Practice Address - Phone:309-697-8416
Practice Address - Fax:309-697-2749
Is Sole Proprietor?:No
Enumeration Date:2005-08-12
Last Update Date:2013-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209004467363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILK05470Medicare ID - Type Unspecified