Provider Demographics
NPI:1790563476
Name:PATTON, ELISABETH A (FNP)
Entity Type:Individual
Prefix:
First Name:ELISABETH
Middle Name:A
Last Name:PATTON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:ELISABETH
Other - Middle Name:A
Other - Last Name:WARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:20 CHEMAR DR
Mailing Address - Street 2:
Mailing Address - City:HURRICANE
Mailing Address - State:WV
Mailing Address - Zip Code:25526-9799
Mailing Address - Country:US
Mailing Address - Phone:304-575-7476
Mailing Address - Fax:
Practice Address - Street 1:4619 KANAWHA AVE SW
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25309-1319
Practice Address - Country:US
Practice Address - Phone:304-400-4545
Practice Address - Fax:304-400-4546
Is Sole Proprietor?:No
Enumeration Date:2023-09-15
Last Update Date:2023-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV117285363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily