Provider Demographics
NPI:1598220261
Name:PATTERSON, DARNETTA L
Entity type:Individual
Prefix:MRS
First Name:DARNETTA
Middle Name:L
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 1:49 MACINTOSH CIR
Mailing Address - Street 2:
Mailing Address - City:MAGNOLIA
Mailing Address - State:DE
Mailing Address - Zip Code:19962-3647
Mailing Address - Country:US
Mailing Address - Phone:215-828-2597
Mailing Address - Fax:
Practice Address - Street 1:49 MACINTOSH CIR
Practice Address - Street 2:
Practice Address - City:MAGNOLIA
Practice Address - State:DE
Practice Address - Zip Code:19962-3647
Practice Address - Country:US
Practice Address - Phone:215-828-2597
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-06
Last Update Date:2019-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL2-0011816251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE251E00000XMedicaid