Provider Demographics
NPI:1437659380
Name:PATTERSON, CYNTHIA DAWN
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:DAWN
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3138 N MUSKINGUM AVE
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:TX
Mailing Address - Zip Code:79762-7650
Mailing Address - Country:US
Mailing Address - Phone:432-557-3659
Mailing Address - Fax:
Practice Address - Street 1:3138 N MUSKINGUM AVE
Practice Address - Street 2:
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79762-7650
Practice Address - Country:US
Practice Address - Phone:432-557-3659
Practice Address - Fax:432-557-3659
Is Sole Proprietor?:No
Enumeration Date:2018-02-16
Last Update Date:2018-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX774565163WC1500X, 163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health