Provider Demographics
NPI:1699085225
Name:PATTERSON, DAPHNE MARIA (NP-C)
Entity type:Individual
Prefix:
First Name:DAPHNE
Middle Name:MARIA
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1585 TUFTSTOWN COURT
Mailing Address - Street 2:
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30078-2583
Mailing Address - Country:US
Mailing Address - Phone:478-251-9538
Mailing Address - Fax:
Practice Address - Street 1:1585 TUFTSTOWN CT
Practice Address - Street 2:
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30078-2583
Practice Address - Country:US
Practice Address - Phone:478-251-9538
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-17
Last Update Date:2012-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN165491AP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily