NPI | 1770681595 |
---|---|
Former Name | PHYLLIS PATTEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN CNP 4348) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 9232460) |
Enumeration Date | 2006-09-20 |
Last Update Date | 2019-03-04 |