Provider Demographics
NPI:1508854670
Name:GAWF-GARCIA, PATRICIA A (FNP)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:A
Last Name:GAWF-GARCIA
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:
Other - Last Name:GAWF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:403 BURKARTH ROAD
Mailing Address - Street 2:
Mailing Address - City:WARRENSBURG
Mailing Address - State:MO
Mailing Address - Zip Code:64093-3101
Mailing Address - Country:US
Mailing Address - Phone:660-262-7580
Mailing Address - Fax:660-262-7581
Practice Address - Street 1:427 BURKARTH ROAD
Practice Address - Street 2:
Practice Address - City:WARRENSBURG
Practice Address - State:MO
Practice Address - Zip Code:64093-3101
Practice Address - Country:US
Practice Address - Phone:660-262-7580
Practice Address - Fax:660-262-7581
Is Sole Proprietor?:No
Enumeration Date:2005-10-12
Last Update Date:2015-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO100030363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO429671829Medicaid
MO429671829Medicaid
MO800006608Medicare PIN
KS7268176BMedicare PIN