Provider Demographics
NPI:1952659914
Name:PATTERSON, CANDICE A
Entity Type:Individual
Prefix:
First Name:CANDICE
Middle Name:A
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 1:700 ASP AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73069-4900
Mailing Address - Country:US
Mailing Address - Phone:405-360-7926
Mailing Address - Fax:405-360-2339
Practice Address - Street 1:700 ASP AVE STE 2
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-4900
Practice Address - Country:US
Practice Address - Phone:405-360-7926
Practice Address - Fax:405-360-2339
Is Sole Proprietor?:No
Enumeration Date:2012-08-24
Last Update Date:2012-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator