Provider Demographics
NPI:1649557992
Name:PATTEN, KATHERINE NICOLE (DPT)
Entity Type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:NICOLE
Last Name:PATTEN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:MRS
Other - First Name:NICOLE
Other - Middle Name:
Other - Last Name:PATTEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DPT
Mailing Address - Street 1:2008 3RD AVE N
Mailing Address - Street 2:APT 6A
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35203-3302
Mailing Address - Country:US
Mailing Address - Phone:334-538-7854
Mailing Address - Fax:
Practice Address - Street 1:5511 HIGHWAY 280
Practice Address - Street 2:SUITE 105
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35242-6585
Practice Address - Country:US
Practice Address - Phone:205-408-0700
Practice Address - Fax:205-408-0702
Is Sole Proprietor?:No
Enumeration Date:2011-11-14
Last Update Date:2013-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH6107225100000X
SC7096225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist