Patrick, Renae M

Patrick, Renae M is an individual health care provider with primary practice located at 420 E Division St , Fond Du Lac WI 54935-4560. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Patrick, Renae M can be contacted via phone (920) 926-5526.

Contact Information

Primary practice address
420 E Division St Fond Du Lac WI 54935-4560
Phone: (920) 926-5526
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 5617-33 Wisconsin

Profile Details

NPI number 1750719050
LBN Legal business name Patrick, Renae M
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 23rd, 2013
Last updated Oct 21st, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1750719050 NPPES
Wisconsin MEDICAID 100035934

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