Provider Demographics
NPI:1952642464
Name:EALY, PATRICIA JO (PHD, APRN-PMHNP)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:JO
Last Name:EALY
Suffix:
Gender:F
Credentials:PHD, APRN-PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4824 E AVE
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68847-8362
Mailing Address - Country:US
Mailing Address - Phone:308-627-2122
Mailing Address - Fax:
Practice Address - Street 1:4824 E AVE
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68847-8362
Practice Address - Country:US
Practice Address - Phone:308-627-2122
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-07
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE113036363LP0808X
CA473499163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty