Provider Demographics
NPI:1073992475
Name:PATTERSON, MEGGAN (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:MEGGAN
Middle Name:
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:MEGGAN
Other - Middle Name:
Other - Last Name:MEISNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1 COOPER PLZ
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08103-1461
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:633 W RITTENHOUSE ST APT A1124
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19144-4396
Practice Address - Country:US
Practice Address - Phone:317-987-8696
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-19
Last Update Date:2019-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA057495363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical