Provider Demographics
NPI:1336493873
Name:PAT MCQUADE,APRN,MSN,LLC
Entity Type:Organization
Organization Name:PAT MCQUADE,APRN,MSN,LLC
Other - Org Name:HEALTHCARE CONSULTANT FOR OLDER ADULTS & DESIGNATED CAREGIVER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:NURSE OWNER AND MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:MCQUADE
Authorized Official - Suffix:
Authorized Official - Credentials:APRN,MSN
Authorized Official - Phone:574-271-7843
Mailing Address - Street 1:1604 BLUE HERON WAY
Mailing Address - Street 2:
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46628-3883
Mailing Address - Country:US
Mailing Address - Phone:574-271-7843
Mailing Address - Fax:
Practice Address - Street 1:1604 BLUE HERON WAY
Practice Address - Street 2:
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46628-3883
Practice Address - Country:US
Practice Address - Phone:574-271-7843
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-06
Last Update Date:2012-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28073706364SA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult HealthGroup - Single Specialty