Provider Demographics
NPI:1417296708
Name:MORE, PATRICIA A (FNP-BC)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:A
Last Name:MORE
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1027 VILLAGE CIR
Mailing Address - Street 2:
Mailing Address - City:WINTERS
Mailing Address - State:CA
Mailing Address - Zip Code:95694-2311
Mailing Address - Country:US
Mailing Address - Phone:530-795-4039
Mailing Address - Fax:
Practice Address - Street 1:2458 HILBORN RD
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94534-1072
Practice Address - Country:US
Practice Address - Phone:707-646-5500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-06
Last Update Date:2019-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21913363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily