Provider Demographics
NPI:1750338174
Name:SOHN, PATRICIA M (MSN, APRN-BC, ANP)
Entity type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:M
Last Name:SOHN
Suffix:
Gender:F
Credentials:MSN, APRN-BC, ANP
Other - Prefix:MRS
Other - First Name:PATRICIA
Other - Middle Name:M
Other - Last Name:RUZICKA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN, APRN-BC, ANP
Mailing Address - Street 1:12639 OLD TESSON RD
Mailing Address - Street 2:SUITE 115
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63128-2786
Mailing Address - Country:US
Mailing Address - Phone:314-849-0311
Mailing Address - Fax:314-849-4423
Practice Address - Street 1:1390 HIGHWAY 61 # B
Practice Address - Street 2:G-1000
Practice Address - City:FESTUS
Practice Address - State:MO
Practice Address - Zip Code:63028-4137
Practice Address - Country:US
Practice Address - Phone:636-933-7400
Practice Address - Fax:636-933-7403
Is Sole Proprietor?:No
Enumeration Date:2006-05-30
Last Update Date:2019-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO064101363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO500025716OtherRAILROAD MEDICARE
MO427295100Medicaid
MO500025716OtherRAILROAD MEDICARE
MO000081281Medicare ID - Type Unspecified