Provider Demographics
NPI:1922376474
Name:BERKOW, PATRICIA LOIS (PNP)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:LOIS
Last Name:BERKOW
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:917 VESTLAKE HOLLOW CIRCLE
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:36242
Mailing Address - Country:US
Mailing Address - Phone:205-967-5723
Mailing Address - Fax:
Practice Address - Street 1:1940 ELMER J. BISSELL ROAD
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35243
Practice Address - Country:US
Practice Address - Phone:205-824-4989
Practice Address - Fax:205-824-4983
Is Sole Proprietor?:No
Enumeration Date:2011-12-12
Last Update Date:2011-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-048187363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics