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General NPI Number Information
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NPI Number | 1275301236
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Entity Type | Individual
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Provider Name | KINLEY NICHOLE PATTERSON
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Gender | Female
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Dates
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Enumeration Date | 12/19/2023
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Last Update Date | 10/13/2025
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Provider Practice Location Address
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Address Line | 4085 HANCOCK BRIDGE PKWY STE 101
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City | NORTH FORT MYERS
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State | FL
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Zip | 33903-7220
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Country | US
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Telephone | 239-677-3767
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Fax |
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Provider Business Mailing Address
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Address Line | 4085 HANCOCK BRIDGE PKWY STE 101
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City | NORTH FORT MYERS
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State | FL
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Zip | 33903-7220
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Country | US
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Telephone | 239-677-3767
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | RBT-23-317322
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | BACB1051572
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License Number State | AL
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