Provider Demographics
NPI:1538135389
Name:MCNAMAR, PATRICIA (DNP, APRN)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:MCNAMAR
Suffix:
Gender:F
Credentials:DNP, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:710 N WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:MEDICINE LODGE
Mailing Address - State:KS
Mailing Address - Zip Code:67104-1019
Mailing Address - Country:US
Mailing Address - Phone:620-886-3771
Mailing Address - Fax:620-930-3781
Practice Address - Street 1:710 N WALNUT ST
Practice Address - Street 2:
Practice Address - City:MEDICINE LODGE
Practice Address - State:KS
Practice Address - Zip Code:67104-1019
Practice Address - Country:US
Practice Address - Phone:620-886-3771
Practice Address - Fax:620-930-3781
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2014-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS45829363LA2200X
KS53-45829-022363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSQ66843Medicare UPIN