Provider Demographics
NPI:1194983148
Name:PATTON, MELISSA A (RN)
Entity type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:A
Last Name:PATTON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 208
Mailing Address - Street 2:
Mailing Address - City:BUTLER
Mailing Address - State:MO
Mailing Address - Zip Code:64730-0208
Mailing Address - Country:US
Mailing Address - Phone:660-679-6108
Mailing Address - Fax:660-679-6022
Practice Address - Street 1:501 N ORANGE ST
Practice Address - Street 2:
Practice Address - City:BUTLER
Practice Address - State:MO
Practice Address - Zip Code:64730-1325
Practice Address - Country:US
Practice Address - Phone:660-679-6108
Practice Address - Fax:660-679-6022
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-27
Last Update Date:2008-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO130886163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse