Provider Demographics
NPI:1982809455
Name:PATTERSON, LISA T (ARNP)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:T
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:107 CORTE DEL ROSA
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34285-3235
Mailing Address - Country:US
Mailing Address - Phone:941-780-2767
Mailing Address - Fax:941-366-7583
Practice Address - Street 1:2020 CATTLEMEN RD
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34232-6243
Practice Address - Country:US
Practice Address - Phone:941-955-5151
Practice Address - Fax:941-366-7582
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-15
Last Update Date:2017-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3281002363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics