Provider Demographics
NPI:1609980481
Name:PATTERSON, MARY LUCAS (APRN-NP)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:LUCAS
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:APRN-NP
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:720 LAKE THURMOND CT
Mailing Address - Street 2:
Mailing Address - City:NORTH AUGUSTA
Mailing Address - State:SC
Mailing Address - Zip Code:29841-7623
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1 FREEDOM WAY
Practice Address - Street 2:VA MEDICAL CENTER, 5C-129
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30904
Practice Address - Country:US
Practice Address - Phone:706-733-0188
Practice Address - Fax:706-823-3911
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN133361 NP363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner