Provider Demographics
NPI:1073165841
Name:PATTERSON, ANDREA LASHEBA
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:LASHEBA
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 HARMON ST STE A
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29072-3526
Mailing Address - Country:US
Mailing Address - Phone:803-467-1343
Mailing Address - Fax:
Practice Address - Street 1:102 HARMON ST STE A
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29072-3526
Practice Address - Country:US
Practice Address - Phone:803-467-1343
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-11
Last Update Date:2019-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant