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General NPI Number Information
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NPI Number | 1245400423
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Entity Type | Individual
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Provider Name | STEFANIE PATTERSON DENDY RPA/RRA
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Gender | Female
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Dates
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Enumeration Date | 03/04/2008
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Last Update Date | 03/04/2008
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Provider Practice Location Address
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Address Line | 825 GRAND AVENUE
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City | YAZOO CITY
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State | MS
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Zip | 39194
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Country | US
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Telephone | 662-751-8164
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Fax | 662-751-8287
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Provider Business Mailing Address
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Address Line | 825 GRAND AVENUE
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City | YAZOO CITY
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State | MS
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Zip | 39194
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Country | US
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Telephone | 662-751-8164
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Fax | 662-751-8287
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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 | 282NR1301X
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Taxonomy Name | Rural Acute Care Hospital
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License Number | MRT1839
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License Number State | MS
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