Basic Information
| Provider Information | |||||||||
| NPI: | 1992806863 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CARRICK | ||||||||
| FirstName: | PATRICIA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 30 HWY 91 S | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | DILLON | ||||||||
| State: | MT | ||||||||
| PostalCode: | 597253513 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4066834440 | ||||||||
| FaxNumber: | 4066831121 | ||||||||
| Practice Location | |||||||||
| Address1: | 30 HWY 91 S | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | DILLON | ||||||||
| State: | MT | ||||||||
| PostalCode: | 597253513 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4066834440 | ||||||||
| FaxNumber: | 4066831121 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/25/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | RN017332 | MT | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.