Provider Demographics
NPI:1932708757
Name:ATKINS, PATRICIA LEE
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:LEE
Last Name:ATKINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2401 LAKEVIEW RD APT 1004
Mailing Address - Street 2:
Mailing Address - City:NORTH LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72116-9099
Mailing Address - Country:US
Mailing Address - Phone:775-217-3901
Mailing Address - Fax:
Practice Address - Street 1:400 W CAPITOL AVE STE 2848
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72201-3415
Practice Address - Country:US
Practice Address - Phone:501-712-3075
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-22
Last Update Date:2020-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVNVMT.10491225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist