Provider Demographics
NPI:1811158041
Name:PATTERSON, NICOLE SAMMONS (MD)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:SAMMONS
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11190 HEALTH PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34110-5729
Mailing Address - Country:US
Mailing Address - Phone:239-552-8572
Mailing Address - Fax:
Practice Address - Street 1:11190 HEALTH PARK BLVD
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34110-5729
Practice Address - Country:US
Practice Address - Phone:239-552-8572
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-20
Last Update Date:2014-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1183692080P0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0204XAllopathic & Osteopathic PhysiciansPediatricsPediatric Emergency Medicine