Basic Information
Provider Information | |||||||||
NPI: | 1851315089 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | PATTERSON | ||||||||
FirstName: | KAREN | ||||||||
MiddleName: | M | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: | CRNA | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: | MERK | ||||||||
OtherFirstName: | KAREN | ||||||||
OtherMiddleName: | M | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: | CRNA | ||||||||
OtherLastNameType: | 1 | ||||||||
Mailing Information | |||||||||
Address1: | P.O. BOX 790309 | ||||||||
Address2: |   | ||||||||
City: | ST. LOUIS | ||||||||
State: | MO | ||||||||
PostalCode: | 631790058 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 6365492380 | ||||||||
FaxNumber: | 3145695974 | ||||||||
Practice Location | |||||||||
Address1: | 5319 HOAG DR. | ||||||||
Address2: |   | ||||||||
City: | ELYRIA | ||||||||
State: | OH | ||||||||
PostalCode: | 440351494 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 4409306050 | ||||||||
FaxNumber: | 4409348882 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 07/27/2006 | ||||||||
LastUpdateDate: | 04/13/2017 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | 00682 | OH | Y |   | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |   |
ID Information
ID | Type | State | Issuer | Description | 430031424 | 01 | OH | RAILROAD MEDICARE | OTHER | 000000516003 | 01 | OH | ANTHEM | OTHER | 000000221184 | 01 | OH | UNISON | OTHER | 0951171 | 05 | OH |   | MEDICAID | 7574912 | 01 | OH | AETNA | OTHER | 0583328 | 01 | OH | BCMH | OTHER | 750946 | 01 | OH | BUCKEYE MEDICAID | OTHER | P00403007 | 01 | OH | MEDICARE RAILROAD | OTHER | 415020 | 01 | OH | WELLCARE MEDICAID | OTHER |