Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 1031770 | TX |
NPI | 1003493818 |
---|---|
Provider Name | Andrea Patterson |
First Address | Dallas, TX 75284-1132 |
Second Address | Temple, TX 76508-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2021 |
Last Update Date | 13/09/2021 |