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General NPI Number Information
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NPI Number | 1821788332
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Entity Type | Individual
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Provider Name | KATELYN PATRICK
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Gender | Female
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Dates
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Enumeration Date | 05/09/2023
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Last Update Date | 07/18/2023
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Provider Practice Location Address
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Address Line | 1 MEDICAL CENTER DR
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City | LEBANON
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State | NH
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Zip | 03756-1000
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Country | US
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Telephone | 603-650-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 10305 CREPE JASMINE LN
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City | FORT MYERS
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State | FL
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Zip | 33913-8877
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Country | US
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Telephone | 239-791-6868
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | XXXXXXX
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 091879-23
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License Number State | NH
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