Healthcare Provider Details

I. General information

NPI: 1275147324
Provider Name (Legal Business Name): KATELYN PATTERSON NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATELYN SHAFFER NP-C

II. Dates (important events)

Enumeration Date: 09/05/2020
Last Update Date: 09/23/2025
Certification Date: 09/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 OAK LEE DR
RANSON WV
25438-4879
US

IV. Provider business mailing address

220 CAMPUS BLVD STE 100
WINCHESTER VA
22601-2896
US

V. Phone/Fax

Practice location:
  • Phone: 304-930-0001
  • Fax: 681-252-1843
Mailing address:
  • Phone: 540-536-5100
  • Fax: 540-536-0235

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberACOO3351
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number106784
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: