Provider Demographics
NPI:1609287911
Name:PATRICK, DAVID ELI JR (RN)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:ELI
Last Name:PATRICK
Suffix:JR
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:190 S MONACO PKWY APT B
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80224-1192
Mailing Address - Country:US
Mailing Address - Phone:720-375-2904
Mailing Address - Fax:
Practice Address - Street 1:190 S MONACO PKWY APT B
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80224-1192
Practice Address - Country:US
Practice Address - Phone:720-375-2904
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-08
Last Update Date:2014-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORN0182127163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse