Provider Demographics
NPI:1528566304
Name:PATTON FAMILY HEALTH
Entity Type:Organization
Organization Name:PATTON FAMILY HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARCY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:PATTON
Authorized Official - Suffix:
Authorized Official - Credentials:CNP
Authorized Official - Phone:970-799-2948
Mailing Address - Street 1:150 E 9TH ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81301-5550
Mailing Address - Country:US
Mailing Address - Phone:970-799-2948
Mailing Address - Fax:
Practice Address - Street 1:150 E 9TH ST
Practice Address - Street 2:SUITE 202
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81301-5550
Practice Address - Country:US
Practice Address - Phone:970-799-2948
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-26
Last Update Date:2018-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0002000-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty