Provider Demographics
NPI:1134638901
Name:PADGETT, PATRICIA M (APRN-BC)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:M
Last Name:PADGETT
Suffix:
Gender:F
Credentials:APRN-BC
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 2147
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33902-2147
Mailing Address - Country:US
Mailing Address - Phone:239-343-1716
Mailing Address - Fax:239-343-1736
Practice Address - Street 1:2776 CLEVELAND AVE STE 808
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33901-5856
Practice Address - Country:US
Practice Address - Phone:239-343-1716
Practice Address - Fax:239-343-1736
Is Sole Proprietor?:No
Enumeration Date:2017-09-25
Last Update Date:2022-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9482558363LA2100X
IL209016644363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL104178200Medicaid