Provider Demographics
NPI:1366636110
Name:PATTERSON, VICKIE LYNN (RN)
Entity Type:Individual
Prefix:MS
First Name:VICKIE
Middle Name:LYNN
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 1:6883 CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:NY
Mailing Address - Zip Code:14001-9663
Mailing Address - Country:US
Mailing Address - Phone:716-946-5092
Mailing Address - Fax:
Practice Address - Street 1:6883 CEDAR ST
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:NY
Practice Address - Zip Code:14001-9663
Practice Address - Country:US
Practice Address - Phone:716-946-5092
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-04
Last Update Date:2007-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY442176-1163WG0000X, 163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice