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General NPI Number Information
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NPI Number | 1730120353
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Entity Type | Individual
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Provider Name | JENNIFER MITCHELL PATTON CRNA
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Gender | Female
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Dates
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Enumeration Date | 06/08/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 100 E WOOD ST SUITE 100
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City | SPARTANBURG
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State | SC
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Zip | 29303-3004
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Country | US
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Telephone | 864-583-1222
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Fax | 864-582-5154
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Provider Business Mailing Address
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Address Line | 596 EDGEWATER RD
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City | WOODRUFF
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State | SC
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Zip | 29388-7818
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Country | US
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Telephone | 864-876-5456
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Fax | 864-876-5456
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | APN617
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License Number State | SC
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