Provider Demographics
NPI:1720683816
Name:PATTERSON, CHRISTINA A
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:A
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 1:919 3RD ST NE
Mailing Address - Street 2:
Mailing Address - City:MINOT
Mailing Address - State:ND
Mailing Address - Zip Code:58703-2437
Mailing Address - Country:US
Mailing Address - Phone:701-509-3939
Mailing Address - Fax:
Practice Address - Street 1:400 BURDICK EXPY E STE 201
Practice Address - Street 2:
Practice Address - City:MINOT
Practice Address - State:ND
Practice Address - Zip Code:58701-4769
Practice Address - Country:US
Practice Address - Phone:701-857-7900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-04
Last Update Date:2020-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDTECH1598183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician