Provider Demographics
NPI:1982657680
Name:SINGLETON, PATRICIA BLAKESLEY (RN MSN FNP)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:BLAKESLEY
Last Name:SINGLETON
Suffix:
Gender:F
Credentials:RN MSN FNP
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:LYNN
Other - Last Name:BLAKESLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:750 WEST RIDGE ROAD
Mailing Address - Street 2:
Mailing Address - City:WYTHEVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24382
Mailing Address - Country:US
Mailing Address - Phone:276-228-5507
Mailing Address - Fax:276-228-3392
Practice Address - Street 1:750 WEST RIDGE ROAD
Practice Address - Street 2:
Practice Address - City:WYTHEVILLE
Practice Address - State:VA
Practice Address - Zip Code:24382
Practice Address - Country:US
Practice Address - Phone:276-228-5507
Practice Address - Fax:276-228-3392
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
005631C68Medicare ID - Type Unspecified