Provider Demographics
NPI:1043383607
Name:DARE, PATRICIA KEHINDE (APRN, PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:KEHINDE
Last Name:DARE
Suffix:
Gender:F
Credentials:APRN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7738 BAR HARBOR DR
Mailing Address - Street 2:
Mailing Address - City:RIVERDALE
Mailing Address - State:GA
Mailing Address - Zip Code:30296-3357
Mailing Address - Country:US
Mailing Address - Phone:678-549-1070
Mailing Address - Fax:
Practice Address - Street 1:450 WINN WAY
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30030-1715
Practice Address - Country:US
Practice Address - Phone:404-294-0499
Practice Address - Fax:404-294-0793
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN106769163W00000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse