1275821407 NPI number — MS. MARY ESTHER PATTERSON CERTIFIED NURSE-MIDW

Table of content: MS. MARY ESTHER PATTERSON CERTIFIED NURSE-MIDW (NPI 1275821407)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1275821407 NPI number — MS. MARY ESTHER PATTERSON CERTIFIED NURSE-MIDW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PATTERSON
Provider First Name:
MARY
Provider Middle Name:
ESTHER
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
CERTIFIED NURSE-MIDW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MAJUSIAK
Provider Other First Name:
MARY
Provider Other Middle Name:
ESTER
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
CNM
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1275821407
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/05/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
236 WEST STREET (OLD)
Provider Second Line Business Mailing Address:
STE 304
Provider Business Mailing Address City Name:
RENO
Provider Business Mailing Address State Name:
NV
Provider Business Mailing Address Postal Code:
89503
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
775-688-6200
Provider Business Mailing Address Fax Number:
775-688-6222

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1441 PULLMAN DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SPARKS
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89434-7921
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
775-432-1343
Provider Business Practice Location Address Fax Number:
775-324-0858
Provider Enumeration Date:
07/21/2011

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LX0001X , with the licence number:  APN00318 , registered in the state of NV ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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