Provider Demographics
NPI:1073883542
Name:PATTON, CHERRY M (NP)
Entity Type:Individual
Prefix:MS
First Name:CHERRY
Middle Name:M
Last Name:PATTON
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:2601 NORTH 7TH
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WEST MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71291
Mailing Address - Country:US
Mailing Address - Phone:318-582-5208
Mailing Address - Fax:318-582-5216
Practice Address - Street 1:2601 NORTH 7TH
Practice Address - Street 2:SUITE 100
Practice Address - City:WEST MONROE
Practice Address - State:LA
Practice Address - Zip Code:71291
Practice Address - Country:US
Practice Address - Phone:318-582-5208
Practice Address - Fax:318-582-5216
Is Sole Proprietor?:No
Enumeration Date:2011-12-30
Last Update Date:2023-01-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
LARN073409-AP06474363LP0200X
LAAP06474363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2425439Medicaid