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General NPI Number Information
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NPI Number | 1073874020
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Entity Type | Individual
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Provider Name | SAMANTHA PATTEN CSFA
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Gender | Female
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Dates
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Enumeration Date | 06/06/2012
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Last Update Date | 10/22/2014
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Provider Practice Location Address
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Address Line | 900 17TH ST SURGERY DEPARTMENT
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City | WOODWARD
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State | OK
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Zip | 73801-2448
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Country | US
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Telephone | 405-301-0183
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Fax |
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Provider Business Mailing Address
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Address Line | 729 38TH ST
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City | WOODWARD
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State | OK
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Zip | 73801-1837
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Country | US
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Telephone | 405-301-0183
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246ZC0007X
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Taxonomy Name | Surgical Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number |
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License Number State |
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