Provider Demographics
NPI:1508690272
Name:PATTERSON, DARRALLYNN SUE (RN)
Entity type:Individual
Prefix:MRS
First Name:DARRALLYNN
Middle Name:SUE
Last Name:PATTERSON
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 1:2103 E 16TH ST
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82001-5147
Mailing Address - Country:US
Mailing Address - Phone:307-287-6990
Mailing Address - Fax:
Practice Address - Street 1:2103 E 16TH ST
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82001-5147
Practice Address - Country:US
Practice Address - Phone:307-287-6990
Practice Address - Fax:307-778-7506
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-27
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY18257163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse