Healthcare Provider Details

I. General information

NPI: 1639456429
Provider Name (Legal Business Name): LENA J PATTON RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/08/2011
Last Update Date: 11/08/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21228 MEADOWBROOK LN
HOWE OK
74940-2008
US

IV. Provider business mailing address

2915 SILVER MAPLE LN
POTEAU OK
74953-8727
US

V. Phone/Fax

Practice location:
  • Phone: 918-658-2189
  • Fax: 918-658-2180
Mailing address:
  • Phone: 918-658-2189
  • Fax: 918-658-2180

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License NumberR0044863
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: