Healthcare Provider Details

I. General information

NPI: 1487233318
Provider Name (Legal Business Name): ADELAIDA FLORITA PATTERSON RN, CDCES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/07/2021
Last Update Date: 04/07/2021
Certification Date: 04/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1650 COCHRANE CIRCLE BLDG 7500 RM 5854
COLORADO SPRINGS CO
80913-4613
US

IV. Provider business mailing address

8409 LUNDEEN PL
COLORADO SPRINGS CO
80925-9588
US

V. Phone/Fax

Practice location:
  • Phone: 719-265-7991
  • Fax:
Mailing address:
  • Phone: 719-360-7224
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License Number0127019
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: