Healthcare Provider Details

I. General information

NPI: 1013714070
Provider Name (Legal Business Name): KATHLEEN PATERSON PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/27/2025
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 HIGH ST STE 9
MOUNT HOLLY NJ
08060-1062
US

IV. Provider business mailing address

22 WINCHESTER CT
HAINESPORT NJ
08036-6246
US

V. Phone/Fax

Practice location:
  • Phone: 609-246-9946
  • Fax: 609-322-8429
Mailing address:
  • Phone: 609-325-1233
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number26NJ15287100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: