Provider Demographics
NPI:1891211538
Name:PATTERSON, KELLI M (NP)
Entity type:Individual
Prefix:
First Name:KELLI
Middle Name:M
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:NP
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1255 W RIO SALADO PKWY
Mailing Address - Street 2:SUITE 107
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85281
Mailing Address - Country:US
Mailing Address - Phone:480-962-0071
Mailing Address - Fax:480-962-0590
Practice Address - Street 1:1255 W RIO SALADO PKWY
Practice Address - Street 2:SUITE 107
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85281
Practice Address - Country:US
Practice Address - Phone:480-962-0071
Practice Address - Fax:480-962-0590
Is Sole Proprietor?:No
Enumeration Date:2017-08-15
Last Update Date:2017-08-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZAP10444363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily