Provider Demographics
NPI:1568597821
Name:PATTERSON, NATALIE NICOLE (COTA)
Entity Type:Individual
Prefix:MRS
First Name:NATALIE
Middle Name:NICOLE
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2015 STATE ROUTE 81
Mailing Address - Street 2:
Mailing Address - City:CENTRAL CITY
Mailing Address - State:KY
Mailing Address - Zip Code:42330
Mailing Address - Country:US
Mailing Address - Phone:270-608-9157
Mailing Address - Fax:
Practice Address - Street 1:1003 BURLEW BLVD
Practice Address - Street 2:UNIT E
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42303-1799
Practice Address - Country:US
Practice Address - Phone:270-688-8449
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYA3708171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor