Provider Demographics
NPI:1801620786
Name:PATTERSON, JOSIE LEEANN
Entity type:Individual
Prefix:
First Name:JOSIE
Middle Name:LEEANN
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 1:117 GAVIN RD
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:AR
Mailing Address - Zip Code:72364-2507
Mailing Address - Country:US
Mailing Address - Phone:901-283-1403
Mailing Address - Fax:
Practice Address - Street 1:117 GAVIN RD
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:AR
Practice Address - Zip Code:72364-2507
Practice Address - Country:US
Practice Address - Phone:901-283-1403
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-31
Last Update Date:2024-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker