Healthcare Provider Details

I. General information

NPI: 1518440791
Provider Name (Legal Business Name): ROBERTA K PATTERSON CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2018
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1050 REID PKWY STE 220
RICHMOND IN
47374-1160
US

IV. Provider business mailing address

1100 REID PARKWAY
RICHMOND IN
47374
US

V. Phone/Fax

Practice location:
  • Phone: 765-962-9541
  • Fax: 765-966-5952
Mailing address:
  • Phone: 765-935-8802
  • Fax: 765-983-3219

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number090003031A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: