Provider Demographics
NPI:1639717440
Name:PHILBRICK, PATRICIA JUNE (APRN)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:JUNE
Last Name:PHILBRICK
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1950 ROCKLEDGE BLVD
Mailing Address - Street 2:STE 101
Mailing Address - City:ROCKLEDGE
Mailing Address - State:FL
Mailing Address - Zip Code:32955-3763
Mailing Address - Country:US
Mailing Address - Phone:321-636-0005
Mailing Address - Fax:321-265-4061
Practice Address - Street 1:1950 ROCKLEDGE BLVD
Practice Address - Street 2:STE 101
Practice Address - City:ROCKLEDGE
Practice Address - State:FL
Practice Address - Zip Code:32955-3763
Practice Address - Country:US
Practice Address - Phone:321-636-0005
Practice Address - Fax:321-265-4061
Is Sole Proprietor?:No
Enumeration Date:2019-12-12
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11003909363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily