Provider Demographics
NPI:1659798692
Name:PHEMESTER, PATRICK HUNT (BA, BSN)
Entity Type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:HUNT
Last Name:PHEMESTER
Suffix:
Gender:M
Credentials:BA, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:439 SW MICHIGAN ST
Mailing Address - Street 2:
Mailing Address - City:LAKE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32025-0440
Mailing Address - Country:US
Mailing Address - Phone:800-330-5615
Mailing Address - Fax:
Practice Address - Street 1:439 SW MICHIGAN ST
Practice Address - Street 2:
Practice Address - City:LAKE CITY
Practice Address - State:FL
Practice Address - Zip Code:32025-0440
Practice Address - Country:US
Practice Address - Phone:800-330-5615
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-27
Last Update Date:2014-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9378882163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse