Provider Demographics
NPI:1801864947
Name:PFAU, PATRICIA ANN (PA-C)
Entity type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:ANN
Last Name:PFAU
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6010 GULL RD
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49048-9452
Mailing Address - Country:US
Mailing Address - Phone:269-385-4671
Mailing Address - Fax:269-385-2657
Practice Address - Street 1:6010 GULL RD
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49048-9452
Practice Address - Country:US
Practice Address - Phone:269-385-4671
Practice Address - Fax:269-385-2657
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5601003307363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical