Provider Demographics
NPI:1417461138
Name:PATTEN SPAHN, AUDRA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:AUDRA
Middle Name:
Last Name:PATTEN SPAHN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:CO
Mailing Address - Zip Code:80751-3034
Mailing Address - Country:US
Mailing Address - Phone:970-522-1302
Mailing Address - Fax:
Practice Address - Street 1:410 W MAIN ST
Practice Address - Street 2:
Practice Address - City:STERLING
Practice Address - State:CO
Practice Address - Zip Code:80751-3034
Practice Address - Country:US
Practice Address - Phone:970-522-1302
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-17
Last Update Date:2017-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO18141183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist