Healthcare Provider Details

I. General information

NPI: 1316092380
Provider Name (Legal Business Name): MONIQUE D PATTEN RN CFNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/23/2007
Last Update Date: 03/28/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

193 LOCUST ST. STE. 2
NORTHAMPTON MA
01060-2066
US

IV. Provider business mailing address

193 LOCUST ST. STE. 2
NORTHAMPTON MA
01060-2066
US

V. Phone/Fax

Practice location:
  • Phone: 413-584-8700
  • Fax: 413-584-1714
Mailing address:
  • Phone: 413-584-8700
  • Fax: 413-584-1714

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number191085
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: