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General NPI Number Information
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NPI Number | 1972669455
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Entity Type | Individual
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Provider Name | RYAN TREVOR PATTERSON DCNP
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Gender | Male
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Dates
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Enumeration Date | 12/29/2006
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Last Update Date | 10/07/2020
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Provider Practice Location Address
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Address Line | 1600 E SPRINGHILL DR
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City | TERRE HAUTE
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State | IN
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Zip | 47802-4363
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Country | US
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Telephone | 812-994-1404
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Fax | 812-742-9420
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Provider Business Mailing Address
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Address Line | PO BOX 3445
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City | INDIANAPOLIS
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State | IN
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Zip | 46206-3445
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Country | US
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Telephone | 812-994-1404
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | AP4948
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | AZ4948
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 71001628A
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License Number State | IN
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Taxonomy #4
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 71001628A
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License Number State | IN
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