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NPI Code Detail

MEDICARE: DESTANY D PATTERSON

MEDICARE: DESTANY D PATTERSON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
13747P1801XPersonal Care Attendant

General Provider Information

NPI Number : 1073271896
Entity Type Code : Individual
Provider Name (Legal Business Name) : DESTANY D PATTERSON
Provider Business Mailing Address
First Line : 1707 US ROUTE 60 W
Second Line :
City : MILTON
State : WV
Zip : 25541-1112
Country : US
Telephone Number : 304-743-8160
Fax Number :
Provider Business Practice Location Address
First Line : 1707 US ROUTE 60 W
Second Line :
City : MILTON
State : WV
Zip : 25541-1112
Country : US
Telephone Number : 304-743-8160
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/30/2021
Last Update Date : 11/30/2021

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Directions to “ DESTANY D PATTERSON ” Practice Location

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