Provider Demographics
NPI:1568078079
Name:ERONINI, PATRICK OKECHUKWU (RN, ACGNP)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:OKECHUKWU
Last Name:ERONINI
Suffix:
Gender:M
Credentials:RN, ACGNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3903
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78540-3903
Mailing Address - Country:US
Mailing Address - Phone:956-309-5315
Mailing Address - Fax:
Practice Address - Street 1:4603 N JACKSON RD STE D
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-6161
Practice Address - Country:US
Practice Address - Phone:956-309-5315
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-20
Last Update Date:2022-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1013975363LA2100X, 363LG0600X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology