Provider Demographics
NPI:1932369337
Name:PATRICK, ANDREW W (APN)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:W
Last Name:PATRICK
Suffix:
Gender:M
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6935-104 ALIANTE PARKWAY
Mailing Address - Street 2:SUITE 509
Mailing Address - City:N. LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89084
Mailing Address - Country:US
Mailing Address - Phone:702-518-8831
Mailing Address - Fax:702-675-7789
Practice Address - Street 1:7495 W AZURE DR STE 232
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89130-4437
Practice Address - Country:US
Practice Address - Phone:702-518-8831
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVAPN001050363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner