Provider Demographics
NPI:1679256846
Name:WEST, PATRICIA M (PHD, RN)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:M
Last Name:WEST
Suffix:
Gender:F
Credentials:PHD, RN
Other - Prefix:
Other - First Name:PATTY
Other - Middle Name:
Other - Last Name:WEST
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD, RN
Mailing Address - Street 1:1355 BOGUE ST. C348 BOTT BUILDING
Mailing Address - Street 2:
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48824-6207
Mailing Address - Country:US
Mailing Address - Phone:517-242-4372
Mailing Address - Fax:
Practice Address - Street 1:1355 BOGUE ST
Practice Address - Street 2:
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48824-6207
Practice Address - Country:US
Practice Address - Phone:517-242-4372
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-14
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704185729163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse