Provider Demographics
NPI:1962710442
Name:PATTERSON, NELDA DEANE (COTA)
Entity type:Individual
Prefix:MS
First Name:NELDA
Middle Name:DEANE
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:MS
Other - First Name:NELDA
Other - Middle Name:DEANE
Other - Last Name:PATTERSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:COTA
Mailing Address - Street 1:406 W SHERMAN ST
Mailing Address - Street 2:
Mailing Address - City:HUTCHINSON
Mailing Address - State:KS
Mailing Address - Zip Code:67501-1739
Mailing Address - Country:US
Mailing Address - Phone:620-663-9957
Mailing Address - Fax:
Practice Address - Street 1:1202 E 23RD AVE
Practice Address - Street 2:
Practice Address - City:HUTCHINSON
Practice Address - State:KS
Practice Address - Zip Code:67502-5656
Practice Address - Country:US
Practice Address - Phone:620-663-9784
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-19
Last Update Date:2010-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS18-00446225400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner