Provider Demographics
NPI:1477002558
Name:PATTEN, AMY REBECCA (ARNP)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:REBECCA
Last Name:PATTEN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:REBECCA
Other - Last Name:DOW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:19246 WOOD SAGE DRIVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647
Mailing Address - Country:US
Mailing Address - Phone:941-704-7479
Mailing Address - Fax:941-792-4048
Practice Address - Street 1:GULFSIDE HOSPICE
Practice Address - Street 2:6117 TROUBLE CREEK ROAD
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34653
Practice Address - Country:US
Practice Address - Phone:813-995-4621
Practice Address - Fax:941-792-4048
Is Sole Proprietor?:No
Enumeration Date:2016-09-29
Last Update Date:2020-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9274058363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner