Provider Demographics
NPI:1588055297
Name:NEUENSCHWANDER, PATRICIA (PNP)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:NEUENSCHWANDER
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9438 LEONA ST
Mailing Address - Street 2:
Mailing Address - City:WHITE LAKE
Mailing Address - State:MI
Mailing Address - Zip Code:48386-2436
Mailing Address - Country:US
Mailing Address - Phone:734-347-3159
Mailing Address - Fax:734-995-4254
Practice Address - Street 1:3131 PROFESSIONAL DR
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48104-5128
Practice Address - Country:US
Practice Address - Phone:734-995-3200
Practice Address - Fax:734-995-4254
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-17
Last Update Date:2015-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704196627363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics