Provider Demographics
NPI:1336356500
Name:FITE, PATRECIA ANN (ARNP)
Entity Type:Individual
Prefix:
First Name:PATRECIA
Middle Name:ANN
Last Name:FITE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:306 N ALPHA AVE
Mailing Address - Street 2:BOX 454
Mailing Address - City:MANGUM
Mailing Address - State:OK
Mailing Address - Zip Code:73554-3602
Mailing Address - Country:US
Mailing Address - Phone:580-782-3702
Mailing Address - Fax:
Practice Address - Street 1:2100 NORTH LOUIS TITTLE AVE
Practice Address - Street 2:BOX 1
Practice Address - City:MANGUM
Practice Address - State:OK
Practice Address - Zip Code:73554
Practice Address - Country:US
Practice Address - Phone:580-782-5531
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK0025234363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics