Provider Demographics
NPI:1316092380
Name:PATTEN, MONIQUE D (RN CFNP)
Entity type:Individual
Prefix:
First Name:MONIQUE
Middle Name:D
Last Name:PATTEN
Suffix:
Gender:F
Credentials:RN CFNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:193 LOCUST ST.
Mailing Address - Street 2:STE. 2
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01060-2066
Mailing Address - Country:US
Mailing Address - Phone:413-584-8700
Mailing Address - Fax:413-584-1714
Practice Address - Street 1:193 LOCUST ST.
Practice Address - Street 2:STE. 2
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-2066
Practice Address - Country:US
Practice Address - Phone:413-584-8700
Practice Address - Fax:413-584-1714
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2012-03-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA191085363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MANP9976OtherMABCBS PROVIDER NUMBER