Provider Demographics
NPI:1073853388
Name:MALONE, PATRICIA M (PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:M
Last Name:MALONE
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:M
Other - Last Name:HESTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:2520 5TH ST N
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:MS
Mailing Address - Zip Code:39705-2008
Mailing Address - Country:US
Mailing Address - Phone:662-244-2561
Mailing Address - Fax:662-286-9836
Practice Address - Street 1:2520 5TH ST N
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:MS
Practice Address - Zip Code:39705-2008
Practice Address - Country:US
Practice Address - Phone:662-244-2561
Practice Address - Fax:662-286-6971
Is Sole Proprietor?:No
Enumeration Date:2013-02-22
Last Update Date:2020-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS903758363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health