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NPI Code Detail

MEDICARE: MONIQUE L PATTERSON CRNA

MEDICARE: MONIQUE L PATTERSON CRNA
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
1367500000XCertified Registered Nurse Anesthetist601782TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1750389359
Entity Type Code : Individual
Provider Name (Legal Business Name) : MONIQUE L PATTERSON CRNA
Provider Business Mailing Address
First Line : 123 RIDGE RD
Second Line :
City : PORTLAND
State : ME
Zip : 04103-4713
Country : US
Telephone Number : 207-415-9955
Fax Number :
Provider Business Practice Location Address
First Line : 22 BRAMHALL ST
Second Line :
City : PORTLAND
State : ME
Zip : 04102-3134
Country : US
Telephone Number : 207-415-9955
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/08/2005
Last Update Date : 03/07/2012

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