Doctor Name: | MR. MICHAEL DALE PATTERSON |
NPI Number: | 1043220247 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | NP |
License Number: | RN077196 AP03525 |
Business Practice Address: | 510 E Stoner Ave Overton Brooks Vamc , Hbpc Shreveport, LA - 711014243 |
Business Phone Number: | 3184246106 |
Business Fax Number: | |
Mailing Address: | 510 E Stoner Ave, Overton Brooks Vamc , Hbpc SHREVEPORT |
State: | LA |
Postal Code: | 711014243 |
Phone Number: | 3184246106 |
Fax Number: | |
NPI Enumeration Date: | 08/09/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LA2100X |
License Number: | RN077196 AP03525 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | LA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Acute Care |
Taxonomy Definition: |