Provider Demographics
NPI:1467822247
Name:PATTISON, LINDA
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:PATTISON
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 1:935 MAIN ST
Mailing Address - Street 2:PO BOX 180198
Mailing Address - City:DELAFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53018-1613
Mailing Address - Country:US
Mailing Address - Phone:262-646-3361
Mailing Address - Fax:
Practice Address - Street 1:935 MAIN ST
Practice Address - Street 2:
Practice Address - City:DELAFIELD
Practice Address - State:WI
Practice Address - Zip Code:53018-1613
Practice Address - Country:US
Practice Address - Phone:262-646-3361
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-06
Last Update Date:2015-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374T00000XNursing Service Related ProvidersReligious Nonmedical Nursing Personnel