Provider Demographics
NPI:1316527567
Name:PATTERSON, SUZANNE LYNNE
Entity type:Individual
Prefix:
First Name:SUZANNE
Middle Name:LYNNE
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4525 VALLEY ST
Mailing Address - Street 2:
Mailing Address - City:ENOLA
Mailing Address - State:PA
Mailing Address - Zip Code:17025-1400
Mailing Address - Country:US
Mailing Address - Phone:717-732-4106
Mailing Address - Fax:
Practice Address - Street 1:4525 VALLEY ST
Practice Address - Street 2:
Practice Address - City:ENOLA
Practice Address - State:PA
Practice Address - Zip Code:17025-1400
Practice Address - Country:US
Practice Address - Phone:717-732-4106
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-12
Last Update Date:2021-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician