Provider Demographics
NPI:1497803308
Name:BORST, PATRICIA A (NP-C)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:A
Last Name:BORST
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 PROFESSIONAL BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47714-8018
Mailing Address - Country:US
Mailing Address - Phone:812-477-7246
Mailing Address - Fax:812-477-7240
Practice Address - Street 1:1101 PROFESSIONAL BLVD STE 100
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47714-8018
Practice Address - Country:US
Practice Address - Phone:812-477-7246
Practice Address - Fax:812-477-7240
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71000377A208VP0014X, 363LF0000X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN71000377AOtherLICENSE
IN200850430Medicaid
KY7100241760Medicaid
IN200850420AMedicaid
IN200850420AMedicaid