Provider Demographics
NPI:1841296449
Name:SCHOVILLE, PATRICIA (NP)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:SCHOVILLE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:824 CASTELLO ST
Mailing Address - Street 2:PO BOX 760
Mailing Address - City:FRASIER
Mailing Address - State:CO
Mailing Address - Zip Code:80440
Mailing Address - Country:US
Mailing Address - Phone:719-836-1900
Mailing Address - Fax:719-836-3283
Practice Address - Street 1:824 CASTELLO
Practice Address - Street 2:
Practice Address - City:FAIRPLAY
Practice Address - State:CO
Practice Address - Zip Code:80440
Practice Address - Country:US
Practice Address - Phone:719-836-1900
Practice Address - Fax:719-836-3282
Is Sole Proprietor?:No
Enumeration Date:2005-06-28
Last Update Date:2009-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO78521363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO11708077Medicaid
S16482Medicare UPIN
CO11708077Medicaid