Provider Demographics
NPI:1952880122
Name:CORTADO, PATRICK ALLEN (MSN FNP-BC PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:PATRICK ALLEN
Middle Name:
Last Name:CORTADO
Suffix:
Gender:M
Credentials:MSN FNP-BC PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2924 LUCAS DR APT 2098
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75219-5597
Mailing Address - Country:US
Mailing Address - Phone:224-430-7848
Mailing Address - Fax:
Practice Address - Street 1:2924 LUCAS DR APT 2098
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75219-5597
Practice Address - Country:US
Practice Address - Phone:224-430-7848
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-08
Last Update Date:2024-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV834537363L00000X
WI8753-33363L00000X, 363LF0000X
IL277001302363L00000X
AZ245123363L00000X
CO0996403363L00000X
HI3344363L00000X
TX1019756363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty