Basic Information
| Provider Information | |||||||||
| NPI: | 1386680692 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PATTERSON | ||||||||
| FirstName: | CARLOTTA | ||||||||
| MiddleName: | JO | ||||||||
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| Credential: | RN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 301 S. COX | ||||||||
| Address2: | PO BOX 385 | ||||||||
| City: | SUBLETTE | ||||||||
| State: | KS | ||||||||
| PostalCode: | 678770385 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6206752718 | ||||||||
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| Practice Location | |||||||||
| Address1: | 712 SAINT JOHN ST | ||||||||
| Address2: | |||||||||
| City: | GARDEN CITY | ||||||||
| State: | KS | ||||||||
| PostalCode: | 678465128 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6202751766 | ||||||||
| FaxNumber: | 6202763346 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/22/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WG0000X | 13-66687-102 | KS | Y | Nursing Service Providers | Registered Nurse | General Practice |
No ID Information.