Provider Demographics
NPI:1538131859
Name:PATTERSON, MAUREEN E (PA-C)
Entity Type:Individual
Prefix:
First Name:MAUREEN
Middle Name:E
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1531 AIRPORT RD STE 102
Mailing Address - Street 2:
Mailing Address - City:AMES
Mailing Address - State:IA
Mailing Address - Zip Code:50010-8211
Mailing Address - Country:US
Mailing Address - Phone:515-620-5352
Mailing Address - Fax:877-375-1824
Practice Address - Street 1:1531 AIRPORT RD STE 102
Practice Address - Street 2:
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50010-8211
Practice Address - Country:US
Practice Address - Phone:515-620-5352
Practice Address - Fax:877-375-1824
Is Sole Proprietor?:No
Enumeration Date:2006-02-02
Last Update Date:2020-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA001300363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
P20357Medicare UPIN