Healthcare Provider Details

I. General information

NPI: 1508914789
Provider Name (Legal Business Name): PATTI C BRATTEN CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/06/2007
Last Update Date: 10/01/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

702 N 13TH ST
ARTESIA NM
88210-1166
US

IV. Provider business mailing address

7577 E WINDROSE DR
SCOTTSDALE AZ
85260-4745
US

V. Phone/Fax

Practice location:
  • Phone: 505-748-3333
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberR48447
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberCRNA0273
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: