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General NPI Number Information
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NPI Number | 1457245060
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Entity Type | Organization
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Legal Business Name | MEDNP HEALTH FAMILY MEDICINE LLC
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Dates
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Enumeration Date | 06/06/2025
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Last Update Date | 06/06/2025
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Provider Practice Location Address
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Address Line | 4001 PENBROOK ST STE 100
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City | ODESSA
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State | TX
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Zip | 79762-5976
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Country | US
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Telephone | 432-352-5627
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Fax |
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Provider Business Mailing Address
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Address Line | 2000 E 42ND ST STE C285
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City | ODESSA
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State | TX
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Zip | 79762-5801
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Country | US
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Telephone | 432-352-5627
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | TASHAWNDA PATTERSON
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Credential | NP
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Telephone | 404-352-4779
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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