Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 12573 | TN |
NPI | 1417096967 |
---|---|
Provider Name | Jill Marie Patterson |
First Address | Nashville, TN 37244-0504 |
Second Address | Knoxville, TN 37920 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/02/2007 |
Last Update Date | 05/09/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3341097 | (05) | TN |