Provider Demographics
NPI:1164776548
Name:PATERSON, KATHERINE D (NP-C)
Entity Type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:D
Last Name:PATERSON
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:D
Other - Last Name:TIMMERMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3311 KELLY LN
Mailing Address - Street 2:
Mailing Address - City:PFLUGERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78660-5058
Mailing Address - Country:US
Mailing Address - Phone:512-983-6140
Mailing Address - Fax:
Practice Address - Street 1:228 SAINT GEORGE ST
Practice Address - Street 2:
Practice Address - City:GONZALES
Practice Address - State:TX
Practice Address - Zip Code:78629-3910
Practice Address - Country:US
Practice Address - Phone:830-672-6511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-06
Last Update Date:2012-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX517795363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner