MEDICARE: ANITRA PATTERSON NPC

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	363LA2100X	Acute Care Nurse Practitioner	RN191854	GA
2	363LG0600X	Gerontology Nurse Practitioner	NP191854	GA
3	363LP2300X	Primary Care Nurse Practitioner	191854	GA
4	207LP2900X	Pain Medicine (Anesthesiology) Physician	RN191854	GA

General Provider Information

NPI Number	:	1619397650
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANITRA PATTERSON NPC

Provider Business Mailing Address
First Line	:	1340 PARC BENCH RD SE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30316-3243
Country	:	US
Telephone Number	:	205-427-8041
Fax Number	:

Provider Business Practice Location Address
First Line	:	1365 CLIFTON RD NE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30322-4570
Country	:	US
Telephone Number	:	404-686-1000
Fax Number	:

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

Provider Enumeration Date	:	04/17/2014
Last Update Date	:	01/07/2026

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Directions to “ ANITRA PATTERSON NPC” Practice Location

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