Provider Demographics
NPI:1659531051
Name:DUNCAN, PATRICIA LYNN (RN BSN)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:LYNN
Last Name:DUNCAN
Suffix:
Gender:F
Credentials:RN BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6076 N WIND PUDDING DR
Mailing Address - Street 2:
Mailing Address - City:HAZELHURST
Mailing Address - State:WI
Mailing Address - Zip Code:54531-9732
Mailing Address - Country:US
Mailing Address - Phone:715-277-4562
Mailing Address - Fax:
Practice Address - Street 1:6076 N WINDPUDDING DR
Practice Address - Street 2:
Practice Address - City:HAZELHURST
Practice Address - State:WI
Practice Address - Zip Code:54531
Practice Address - Country:US
Practice Address - Phone:715-277-4562
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-10
Last Update Date:2008-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI74583030163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI35061200Medicaid