Provider Demographics
NPI:1982143889
Name:PATTON, MARIE S (CNP)
Entity type:Individual
Prefix:
First Name:MARIE
Middle Name:S
Last Name:PATTON
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6020
Mailing Address - Street 2:
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57701-4677
Mailing Address - Country:US
Mailing Address - Phone:605-718-2018
Mailing Address - Fax:605-388-4617
Practice Address - Street 1:717 SAINT FRANCIS ST
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57701
Practice Address - Country:US
Practice Address - Phone:605-718-2018
Practice Address - Fax:605-388-4617
Is Sole Proprietor?:No
Enumeration Date:2017-02-13
Last Update Date:2021-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDR039179163W00000X
SDCP001184363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse