Provider Demographics
NPI:1033557384
Name:PATTERSON, KRISTEN LYNNE (DPM)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:LYNNE
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42550 GARFIELD RD
Mailing Address - Street 2:STE 103
Mailing Address - City:CLINTON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48038-1644
Mailing Address - Country:US
Mailing Address - Phone:313-808-0559
Mailing Address - Fax:
Practice Address - Street 1:42550 GARFIELD RD STE 103
Practice Address - Street 2:
Practice Address - City:CLINTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48038
Practice Address - Country:US
Practice Address - Phone:586-263-4411
Practice Address - Fax:586-263-1151
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-10
Last Update Date:2018-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5901002613213ES0103X
MI5315074411213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery