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NPI Code Detail

MEDICARE: KACHENA PATTERSON LPN

MEDICARE:   KACHENA  PATTERSON  LPN
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
1164W00000XLicensed Practical Nurse4703104881MI

General Provider Information

NPI Number : 1972832822
Entity Type Code : Individual
Provider Name (Legal Business Name) : KACHENA PATTERSON LPN
Provider Business Mailing Address
First Line : 2320 BENSTEIN RD
Second Line :
City : WOLVERINE LAKE
State : MI
Zip : 48390-1813
Country : US
Telephone Number : 248-881-4814
Fax Number :
Provider Business Practice Location Address
First Line : 2320 BENSTEIN RD
Second Line :
City : WOLVERINE LAKE
State : MI
Zip : 48390-1813
Country : US
Telephone Number : 248-881-4814
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/23/2009
Last Update Date : 12/23/2009

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Directions to “ KACHENA PATTERSON LPN” Practice Location

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