Provider Demographics
NPI:1932396629
Name:KING, PATRICE ELIZABETH (RN, BSN)
Entity Type:Individual
Prefix:MRS
First Name:PATRICE
Middle Name:ELIZABETH
Last Name:KING
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:MISS
Other - First Name:PATRICE
Other - Middle Name:ELIZABETH
Other - Last Name:PANULA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7400 MERTON MINTER ST
Mailing Address - Street 2:SPINAL CORD INJURY 617-128
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-4404
Mailing Address - Country:US
Mailing Address - Phone:210-617-5300
Mailing Address - Fax:210-949-3327
Practice Address - Street 1:7400 MERTON MINTER ST
Practice Address - Street 2:SPINAL CORD INJURY 617-128
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-4404
Practice Address - Country:US
Practice Address - Phone:210-617-5300
Practice Address - Fax:210-949-3327
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-27
Last Update Date:2007-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX595474163WR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0400XNursing Service ProvidersRegistered NurseRehabilitation