Provider Demographics
NPI:1982065504
Name:PATTERSON, LATOYA ANN (CRNP)
Entity Type:Individual
Prefix:
First Name:LATOYA
Middle Name:ANN
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1304 13TH AVE SE STE D
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35601-4316
Mailing Address - Country:US
Mailing Address - Phone:256-355-7665
Mailing Address - Fax:256-686-3241
Practice Address - Street 1:1304 13TH AVE SE STE D
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35601-4316
Practice Address - Country:US
Practice Address - Phone:256-355-7665
Practice Address - Fax:256-686-3241
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-09
Last Update Date:2016-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-136255363LF0000X, 363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics