Healthcare Provider Details

I. General information

NPI: 1336103035
Provider Name (Legal Business Name): CAMILLE MARIE PATTI NP,RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/12/2006
Last Update Date: 07/31/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8401 MEDICAL PLAZA DR SUITE 300
CHARLOTTE NC
28262-8797
US

IV. Provider business mailing address

3434 TURTLE CROSS LN
CHARLOTTE NC
28269-9329
US

V. Phone/Fax

Practice location:
  • Phone: 704-547-0020
  • Fax:
Mailing address:
  • Phone: 704-594-9771
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number190583
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number128236
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: