Provider Demographics
NPI:1477110161
Name:DEAN-PATTERSON, NAEISHA (S/T, BS)
Entity Type:Individual
Prefix:
First Name:NAEISHA
Middle Name:
Last Name:DEAN-PATTERSON
Suffix:
Gender:F
Credentials:S/T, BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5328
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31906-0328
Mailing Address - Country:US
Mailing Address - Phone:706-596-5900
Mailing Address - Fax:
Practice Address - Street 1:5443 ARMOUR RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31909-4580
Practice Address - Country:US
Practice Address - Phone:706-681-5519
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-29
Last Update Date:2019-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program