Provider Demographics
NPI:1972527117
Name:PATTERSON, NONA LOUISE (PHD)
Entity Type:Individual
Prefix:DR
First Name:NONA
Middle Name:LOUISE
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4425 RANDOLPH RD
Mailing Address - Street 2:SUITE 411
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28211-2351
Mailing Address - Country:US
Mailing Address - Phone:704-366-3400
Mailing Address - Fax:704-362-1170
Practice Address - Street 1:4425 RANDOLPH RD
Practice Address - Street 2:SUITE 411
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28211-2351
Practice Address - Country:US
Practice Address - Phone:704-366-3400
Practice Address - Fax:704-362-1170
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1636103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0344NOtherBLUE CROSS BLUE SHIELD
NC25661OtherMAGELLEN
NC2814074Medicare ID - Type UnspecifiedMEDICARE