Provider Demographics
NPI:1205017787
Name:PATTERSON, ROXANNE M (LPN)
Entity Type:Individual
Prefix:MISS
First Name:ROXANNE
Middle Name:M
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1054 CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:PHILA
Mailing Address - State:PA
Mailing Address - Zip Code:19023
Mailing Address - Country:US
Mailing Address - Phone:610-733-6039
Mailing Address - Fax:
Practice Address - Street 1:2250 HICKORY ROAD SUITE 240
Practice Address - Street 2:
Practice Address - City:PLYMOUTH MEETING
Practice Address - State:PA
Practice Address - Zip Code:19462
Practice Address - Country:US
Practice Address - Phone:180-087-9447
Practice Address - Fax:610-834-7525
Is Sole Proprietor?:No
Enumeration Date:2007-11-26
Last Update Date:2007-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPN260770L164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse