Provider Demographics
NPI:1447684360
Name:COLVIN, PATRICIA ANNE (PA-C)
Entity type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:ANNE
Last Name:COLVIN
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 1:73-5618 MAIAU ST
Mailing Address - Street 2:SUITE A204
Mailing Address - City:KAILUA KONA
Mailing Address - State:HI
Mailing Address - Zip Code:96740-2616
Mailing Address - Country:US
Mailing Address - Phone:808-329-1146
Mailing Address - Fax:808-329-1120
Practice Address - Street 1:73-5618 MAIAU ST
Practice Address - Street 2:SUITE A204
Practice Address - City:KAILUA KONA
Practice Address - State:HI
Practice Address - Zip Code:96740-2616
Practice Address - Country:US
Practice Address - Phone:808-329-1146
Practice Address - Fax:808-329-1120
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-27
Last Update Date:2013-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAMD260363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant