Provider Demographics
NPI:1255761466
Name:PATRICK, AMY (ARNP)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:PATRICK
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:PATRICK
Other - Last Name:CHAPIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:2145 CENTENNIAL PLZ
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-2474
Mailing Address - Country:US
Mailing Address - Phone:541-485-6340
Mailing Address - Fax:541-984-3124
Practice Address - Street 1:2145 CENTENNIAL PLZ
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401
Practice Address - Country:US
Practice Address - Phone:541-485-6340
Practice Address - Fax:541-984-3124
Is Sole Proprietor?:No
Enumeration Date:2013-11-25
Last Update Date:2018-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201502913NP-PP363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health