Provider Demographics
NPI:1992755219
Name:PATTERSON, JANET L (NP)
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:L
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1248 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:ST JOHNSBURY
Mailing Address - State:VT
Mailing Address - Zip Code:05819-9248
Mailing Address - Country:US
Mailing Address - Phone:802-748-8757
Mailing Address - Fax:802-748-6503
Practice Address - Street 1:1248 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:ST JOHNSBURY
Practice Address - State:VT
Practice Address - Zip Code:05819-9239
Practice Address - Country:US
Practice Address - Phone:802-748-8757
Practice Address - Fax:802-748-8757
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2019-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT101.0134224363LA2200X
MA155989363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MANP0161OtherBCBS MA
MA0391701Medicaid
MAS722OtherHARVARD PILGRIM
MA000000025874OtherBMC HEALTHNET
MA604436OtherTUFTS HEALTH PLAN
MAH2672OtherRAILROAD MEDICARE
MA604436OtherSECURE HORIZONS
MA604436OtherSECURE HORIZONS