Provider Demographics
NPI:1336410133
Name:PATTERSON, JENNIFER ALTAMURO (ANP-BC)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:ALTAMURO
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:ANP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:732 W. BIRCHTREE LANE
Mailing Address - Street 2:
Mailing Address - City:CLAYMONT
Mailing Address - State:DE
Mailing Address - Zip Code:19703
Mailing Address - Country:US
Mailing Address - Phone:215-431-7537
Mailing Address - Fax:
Practice Address - Street 1:732 W BIRCHTREE LN
Practice Address - Street 2:
Practice Address - City:CLAYMONT
Practice Address - State:DE
Practice Address - Zip Code:19703-1603
Practice Address - Country:US
Practice Address - Phone:215-431-7537
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-25
Last Update Date:2012-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELB0000218363LA2200X
PASP008164363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health