Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 5315074411 | MI |
N | 213ES0103X | Foot & Ankle Surgery | 5901002613 | MI |
NPI | 1033557384 |
---|---|
Provider Name | Kristen Lynne Patterson |
First Address | Clinton Township, MI 48038-1644 |
Second Address | Clinton Township, MI 48038 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2013 |
Last Update Date | 16/05/2018 |