Provider Demographics
NPI:1457574535
Name:GEORGE, PATRICIA WEEKS (MSN, CGNP)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:WEEKS
Last Name:GEORGE
Suffix:
Gender:F
Credentials:MSN, CGNP
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:ELLA
Other - Last Name:WEEKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:302 CARRIAGE DR
Mailing Address - Street 2:
Mailing Address - City:BECKLEY
Mailing Address - State:WV
Mailing Address - Zip Code:25801-2812
Mailing Address - Country:US
Mailing Address - Phone:304-250-0333
Mailing Address - Fax:304-250-0334
Practice Address - Street 1:302 CARRIAGE DR
Practice Address - Street 2:
Practice Address - City:BECKLEY
Practice Address - State:WV
Practice Address - Zip Code:25801-2812
Practice Address - Country:US
Practice Address - Phone:304-250-0333
Practice Address - Fax:304-250-0334
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV21863363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810000295Medicaid
WV3810000295Medicaid