Provider Demographics
NPI:1144232190
Name:PATTERSON, KATHY LYNN (FNP)
Entity Type:Individual
Prefix:
First Name:KATHY
Middle Name:LYNN
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 608
Mailing Address - Street 2:
Mailing Address - City:YANCEYVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27379-0608
Mailing Address - Country:US
Mailing Address - Phone:336-694-6969
Mailing Address - Fax:336-694-1266
Practice Address - Street 1:1499 MAIN ST
Practice Address - Street 2:
Practice Address - City:YANCEYVILLE
Practice Address - State:NC
Practice Address - Zip Code:27379
Practice Address - Country:US
Practice Address - Phone:336-694-6969
Practice Address - Fax:336-694-1266
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-11
Last Update Date:2013-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC201723363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2808886AMedicare PIN
NCP96656Medicare UPIN