Provider Demographics
NPI:1083924369
Name:JAMES, PATTI RENEE (RN, NNP-BC)
Entity Type:Individual
Prefix:
First Name:PATTI
Middle Name:RENEE
Last Name:JAMES
Suffix:
Gender:F
Credentials:RN, NNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3534 W CHEVAUX DR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72704-6978
Mailing Address - Country:US
Mailing Address - Phone:501-681-3481
Mailing Address - Fax:
Practice Address - Street 1:3534 W CHEVAUX DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72704-6978
Practice Address - Country:US
Practice Address - Phone:501-681-3481
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-20
Last Update Date:2010-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX763022363LN0000X
ARAO3420363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal