1649557992 NPI number — MRS. KATHERINE NICOLE PATTEN DPT

Table of content: MRS. KATHERINE NICOLE PATTEN DPT (NPI 1649557992)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649557992 NPI number — MRS. KATHERINE NICOLE PATTEN DPT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PATTEN
Provider First Name:
KATHERINE
Provider Middle Name:
NICOLE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
DPT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
PATTEN
Provider Other First Name:
NICOLE
Provider Other Middle Name:
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
DPT
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1649557992
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/08/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2008 3RD AVE N
Provider Second Line Business Mailing Address:
APT 6A
Provider Business Mailing Address City Name:
BIRMINGHAM
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35203-3302
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
334-538-7854
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5511 HIGHWAY 280
Provider Second Line Business Practice Location Address:
SUITE 105
Provider Business Practice Location Address City Name:
BIRMINGHAM
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35242-6585
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-408-0700
Provider Business Practice Location Address Fax Number:
205-408-0702
Provider Enumeration Date:
11/14/2011

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: 225100000X , with the licence number:  PTH6107 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 225100000X , with the licence number: 7096 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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





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