Provider Demographics
NPI:1649872334
Name:ST. LEGER, PATRICK (FNP-C)
Entity type:Individual
Prefix:
First Name:PATRICK
Middle Name:
Last Name:ST. LEGER
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6688 SW 59TH ST
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34474-5544
Mailing Address - Country:US
Mailing Address - Phone:352-286-1096
Mailing Address - Fax:
Practice Address - Street 1:135 PARK ST
Practice Address - Street 2:
Practice Address - City:MILO
Practice Address - State:ME
Practice Address - Zip Code:04463-1729
Practice Address - Country:US
Practice Address - Phone:207-943-7752
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-09
Last Update Date:2023-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9434475163WE0003X
FLAPRN11010456363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WE0003XNursing Service ProvidersRegistered NurseEmergency