Provider Demographics
NPI:1720794480
Name:PATTERSON, CRAIG STEVEN (RN)
Entity Type:Individual
Prefix:
First Name:CRAIG
Middle Name:STEVEN
Last Name:PATTERSON
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 TOWNSHIP ROAD 167
Mailing Address - Street 2:
Mailing Address - City:MINGO JUNCTION
Mailing Address - State:OH
Mailing Address - Zip Code:43938-7908
Mailing Address - Country:US
Mailing Address - Phone:740-317-2921
Mailing Address - Fax:
Practice Address - Street 1:1479 3RD ST
Practice Address - Street 2:
Practice Address - City:BRILLIANT
Practice Address - State:OH
Practice Address - Zip Code:43913-1000
Practice Address - Country:US
Practice Address - Phone:740-598-2054
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-26
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.330165163WA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)