Provider Demographics
NPI:1942360649
Name:PATTON, ANGELA R (RN)
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:R
Last Name:PATTON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4000 JENNINGS STATION RD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63121-3323
Mailing Address - Country:US
Mailing Address - Phone:314-679-7818
Mailing Address - Fax:314-679-7876
Practice Address - Street 1:4000 JENNINGS STATION RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63121-3323
Practice Address - Country:US
Practice Address - Phone:314-679-7818
Practice Address - Fax:314-679-7876
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO078286163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health