Provider Demographics
NPI:1508046772
Name:JAMES, PATRICIA MARIE
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:MARIE
Last Name:JAMES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:MARIE
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:1580 W ANTELOPE DR
Mailing Address - Street 2:SUITE 290
Mailing Address - City:LAYTON
Mailing Address - State:UT
Mailing Address - Zip Code:84041-1160
Mailing Address - Country:US
Mailing Address - Phone:801-776-0880
Mailing Address - Fax:801-773-7399
Practice Address - Street 1:1580 W ANTELOPE DR
Practice Address - Street 2:SUITE 290
Practice Address - City:LAYTON
Practice Address - State:UT
Practice Address - Zip Code:84041-1160
Practice Address - Country:US
Practice Address - Phone:801-776-0880
Practice Address - Fax:801-773-7399
Is Sole Proprietor?:No
Enumeration Date:2007-11-05
Last Update Date:2010-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT53021234408363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology