Provider Demographics
NPI:1720429723
Name:FINKENHOEFER, PATRICIA S (NP)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:S
Last Name:FINKENHOEFER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:980 LAWRENCEVILLE HWY
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30046-4706
Mailing Address - Country:US
Mailing Address - Phone:770-962-8025
Mailing Address - Fax:770-822-1573
Practice Address - Street 1:3815 HARRISON RD
Practice Address - Street 2:
Practice Address - City:LOGANVILLE
Practice Address - State:GA
Practice Address - Zip Code:30052-2462
Practice Address - Country:US
Practice Address - Phone:770-466-6112
Practice Address - Fax:770-466-6201
Is Sole Proprietor?:No
Enumeration Date:2013-07-08
Last Update Date:2013-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GURN071833363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics