Provider Demographics
NPI:1073966230
Name:PATEL, PRIYA (RN, BSN, FNP)
Entity Type:Individual
Prefix:MRS
First Name:PRIYA
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:RN, BSN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 650
Mailing Address - Street 2:
Mailing Address - City:EDWARDSVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62025-0650
Mailing Address - Country:US
Mailing Address - Phone:314-502-3994
Mailing Address - Fax:914-810-9609
Practice Address - Street 1:2000 PEPPERELL PKWY
Practice Address - Street 2:2ND FLOOR (PAIN CLINIC)
Practice Address - City:OPELIKA
Practice Address - State:AL
Practice Address - Zip Code:36801-5452
Practice Address - Country:US
Practice Address - Phone:334-528-2400
Practice Address - Fax:334-528-2495
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-22
Last Update Date:2021-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-091600207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine