MEDICARE: MS. KATHLEEN ANN PATTERSON FNP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	APRN002608	NV

General Provider Information

NPI Number	:	1407370265
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KATHLEEN ANN PATTERSON FNP-C

Provider Business Mailing Address
First Line	:	850 HARVARD WAY
Second Line	:
City	:	RENO
State	:	NV
Zip	:	89502-2055
Country	:	US
Telephone Number	:	775-982-5262
Fax Number	:	775-982-5496

Provider Business Practice Location Address
First Line	:	560 E WILLIAMS AVE
Second Line	:
City	:	FALLON
State	:	NV
Zip	:	89406-3031
Country	:	US
Telephone Number	:	775-982-5000
Fax Number	:	775-982-2988

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/02/2017
Last Update Date	:	05/06/2019

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