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NPI Code Detail

MEDICARE: MISS KEIANNA PATTON

MEDICARE: MISS KEIANNA PATTON
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
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1992472179
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS KEIANNA PATTON
Provider Business Mailing Address
First Line : 1898 AFRICA RD
Second Line :
City : LEBANON
State : TN
Zip : 37087-7309
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1535 N MOUNT JULIET RD
Second Line :
City : MT JULIET
State : TN
Zip : 37122-3315
Country : US
Telephone Number : 615-560-6622
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/25/2021
Last Update Date : 08/25/2021

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Directions to “ MISS KEIANNA PATTON ” Practice Location

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