Provider Demographics
NPI:1104475987
Name:PATTERSON, TESSA BROOKE (WHNP)
Entity type:Individual
Prefix:MS
First Name:TESSA
Middle Name:BROOKE
Last Name:PATTERSON
Suffix:
Gender:
Credentials:WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 7412011
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60674-2011
Mailing Address - Country:US
Mailing Address - Phone:314-362-4211
Mailing Address - Fax:888-315-6494
Practice Address - Street 1:4901 FOREST PARK AVE
Practice Address - Street 2:DEPT OBGYN, STE 710
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63108-1495
Practice Address - Country:US
Practice Address - Phone:314-362-4211
Practice Address - Fax:888-315-6494
Is Sole Proprietor?:No
Enumeration Date:2019-09-05
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2024024797363LW0102X
IL209024236363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO420149687Medicaid