Healthcare Provider Details

I. General information

NPI: 1154244242
Provider Name (Legal Business Name): CRYSTAL MICHELLE PATTERSON RN, CDRMS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2026
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 MAINE ST
LAWRENCE KS
66044-1360
US

IV. Provider business mailing address

317 SETTLERS DR
LAWRENCE KS
66049-2031
US

V. Phone/Fax

Practice location:
  • Phone: 785-505-5000
  • Fax:
Mailing address:
  • Phone: 785-505-4005
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number13-114020
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: