Provider Demographics
NPI:1447510433
Name:PATTERSON, SANDRA (FNP-BC)
Entity type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2114 S DUPONT HWY STE 1
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:DE
Mailing Address - Zip Code:19934-1249
Mailing Address - Country:US
Mailing Address - Phone:302-697-0515
Mailing Address - Fax:302-697-0415
Practice Address - Street 1:2114 S DUPONT HWY STE 1
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:DE
Practice Address - Zip Code:19934-1249
Practice Address - Country:US
Practice Address - Phone:302-697-0515
Practice Address - Fax:302-697-0415
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-23
Last Update Date:2012-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELG0000510363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner