Provider Demographics
NPI:1174930218
Name:PATTERSON, CHRISTOPHER (RN)
Entity type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:
Last Name:PATTERSON
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11818 EMERY VILLAGE DR N
Mailing Address - Street 2:
Mailing Address - City:CHAMPLIN
Mailing Address - State:MN
Mailing Address - Zip Code:55316-2490
Mailing Address - Country:US
Mailing Address - Phone:612-695-1771
Mailing Address - Fax:
Practice Address - Street 1:11818 EMERY VILLAGE DR N
Practice Address - Street 2:
Practice Address - City:CHAMPLIN
Practice Address - State:MN
Practice Address - Zip Code:55316-2490
Practice Address - Country:US
Practice Address - Phone:612-695-1771
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-21
Last Update Date:2014-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR1978704163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse