Healthcare Provider Details

I. General information

NPI: 1205193406
Provider Name (Legal Business Name): CHRISTINA E PATTON BC-HIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2012
Last Update Date: 04/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5010 E WARNER RD SUITE 107
PHOENIX AZ
85044-3311
US

IV. Provider business mailing address

5010 E WARNER RD SUITE 107
PHOENIX AZ
85044-3311
US

V. Phone/Fax

Practice location:
  • Phone: 480-245-6055
  • Fax: 480-993-3124
Mailing address:
  • Phone: 480-245-6055
  • Fax: 480-993-3124

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberHAD6191
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: