Provider Demographics
NPI:1932475829
Name:PATTERSON, JAALAH H
Entity Type:Individual
Prefix:MRS
First Name:JAALAH
Middle Name:H
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1006 HOLLOW OAK DR
Mailing Address - Street 2:
Mailing Address - City:TAYLORS
Mailing Address - State:SC
Mailing Address - Zip Code:29687-4455
Mailing Address - Country:US
Mailing Address - Phone:864-640-0197
Mailing Address - Fax:
Practice Address - Street 1:1006 HOLLOW OAK DR
Practice Address - Street 2:
Practice Address - City:TAYLORS
Practice Address - State:SC
Practice Address - Zip Code:29687-4455
Practice Address - Country:US
Practice Address - Phone:864-640-0197
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-26
Last Update Date:2012-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula