MEDICARE: ANDREA PATTEN

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
1	1041C0700X	Clinical Social Worker	20032	MN

General Provider Information

NPI Number	:	1396025383
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREA PATTEN

Provider Business Mailing Address
First Line	:	1250 MOORE LAKE DR E STE 152
Second Line	:
City	:	FRIDLEY
State	:	MN
Zip	:	55432-5135
Country	:	US
Telephone Number	:	612-389-2332
Fax Number	:	612-389-2338

Provider Business Practice Location Address
First Line	:	1250 MOORE LAKE DR E STE 152
Second Line	:
City	:	FRIDLEY
State	:	MN
Zip	:	55432-5135
Country	:	US
Telephone Number	:	612-389-2332
Fax Number	:	612-389-2338

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/22/2011
Last Update Date	:	10/28/2025

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Directions to “ ANDREA PATTEN ” Practice Location

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