Provider Demographics
NPI:1053050211
Name:PATTERSON, AMY MICHELLE (FNP-C)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:MICHELLE
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:407 RAMSEY DR
Mailing Address - Street 2:
Mailing Address - City:STONEWALL
Mailing Address - State:LA
Mailing Address - Zip Code:71078-9651
Mailing Address - Country:US
Mailing Address - Phone:318-464-9928
Mailing Address - Fax:
Practice Address - Street 1:149 STONE CREEK RD
Practice Address - Street 2:
Practice Address - City:STONEWALL
Practice Address - State:LA
Practice Address - Zip Code:71078-4906
Practice Address - Country:US
Practice Address - Phone:318-688-3350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-03
Last Update Date:2022-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA225866363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily