Provider Demographics
NPI:1083384986
Name:PATRICK, BIBIANA GARCIA (PA-C)
Entity Type:Individual
Prefix:
First Name:BIBIANA
Middle Name:GARCIA
Last Name:PATRICK
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:BIBIANA
Other - Middle Name:
Other - Last Name:GARCIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:552 BRUNING LN
Mailing Address - Street 2:
Mailing Address - City:RED BANK
Mailing Address - State:TN
Mailing Address - Zip Code:37415-6205
Mailing Address - Country:US
Mailing Address - Phone:706-589-1190
Mailing Address - Fax:
Practice Address - Street 1:1300 E 23RD ST
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37404-5701
Practice Address - Country:US
Practice Address - Phone:423-760-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-14
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4700363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical