Provider Demographics
NPI:1336188895
Name:PATTERSON, SCOTT NOLAN (RPH)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:NOLAN
Last Name:PATTERSON
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 FREDERICK ST
Mailing Address - Street 2:
Mailing Address - City:CLAY CENTER
Mailing Address - State:KS
Mailing Address - Zip Code:67432-1916
Mailing Address - Country:US
Mailing Address - Phone:785-632-3115
Mailing Address - Fax:785-632-3777
Practice Address - Street 1:422 LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:CLAY CENTER
Practice Address - State:KS
Practice Address - Zip Code:67432-2908
Practice Address - Country:US
Practice Address - Phone:785-632-3115
Practice Address - Fax:785-632-3777
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2020-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS9267183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist