Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 26NJ00317700 | NJ |
N | 363LF0000X | Nurse Practitioner - Family Medicine | 26NJ00317700 | NJ |
NPI | 1467757815 |
---|---|
Provider Name | Ms. Mindy Patterson |
First Address | Lawrenceville, NJ 08648-2201 |
Second Address | Marlton, NJ 08053-1855 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/01/2011 |
Last Update Date | 14/05/2021 |