Provider Demographics
NPI:1255819405
Name:PATTEN, NICHOLE MARIE (DNP, FNP-BC)
Entity type:Individual
Prefix:DR
First Name:NICHOLE
Middle Name:MARIE
Last Name:PATTEN
Suffix:
Gender:F
Credentials:DNP, FNP-BC
Other - Prefix:
Other - First Name:NICHOLE
Other - Middle Name:MARIE
Other - Last Name:PATTEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DNP, FNP-BC
Mailing Address - Street 1:2214 COLDSPRING RD
Mailing Address - Street 2:
Mailing Address - City:CROWN POINT
Mailing Address - State:IN
Mailing Address - Zip Code:46307-9335
Mailing Address - Country:US
Mailing Address - Phone:219-331-6677
Mailing Address - Fax:
Practice Address - Street 1:1500 S LAKE PARK AVE
Practice Address - Street 2:
Practice Address - City:HOBART
Practice Address - State:IN
Practice Address - Zip Code:46342-6638
Practice Address - Country:US
Practice Address - Phone:219-947-6200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-31
Last Update Date:2022-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28211762A363L00000X
IN71008400A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner