Provider Demographics
NPI:1164127890
Name:PATTERSON, MARISSA LAUREN (RN)
Entity Type:Individual
Prefix:
First Name:MARISSA
Middle Name:LAUREN
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 1:20 HEDMAN AVE
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:NH
Mailing Address - Zip Code:03842-4021
Mailing Address - Country:US
Mailing Address - Phone:603-380-5517
Mailing Address - Fax:
Practice Address - Street 1:20 HEDMAN AVE
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:NH
Practice Address - Zip Code:03842-4021
Practice Address - Country:US
Practice Address - Phone:603-380-5517
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-03
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2368459163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse