Healthcare Provider Details

I. General information

NPI: 1780147405
Provider Name (Legal Business Name): DENISE MARIE PATTERSON PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2019
Last Update Date: 12/30/2025
Certification Date: 12/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5055 E BROADWAY BLVD STE A200
TUCSON AZ
85711-3649
US

IV. Provider business mailing address

PO BOX 86537
TUCSON AZ
85754-6537
US

V. Phone/Fax

Practice location:
  • Phone: 520-901-4800
  • Fax: 520-318-6979
Mailing address:
  • Phone: 520-721-1887
  • Fax: 520-372-7126

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number222688
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: