Provider Demographics
NPI:1053487645
Name:PATTERSON, AMY SUSAN (RN)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:SUSAN
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6668 MILESTRIP RD
Mailing Address - Street 2:
Mailing Address - City:ORCHARD PARK
Mailing Address - State:NY
Mailing Address - Zip Code:14127-1610
Mailing Address - Country:US
Mailing Address - Phone:716-662-3368
Mailing Address - Fax:
Practice Address - Street 1:2303 KENMORE AVE
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14207-1311
Practice Address - Country:US
Practice Address - Phone:716-876-5845
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-27
Last Update Date:2011-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY487991-1163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool