Provider Demographics
NPI:1518752005
Name:PATTERSON, SHANDA MARIE
Entity type:Individual
Prefix:
First Name:SHANDA
Middle Name:MARIE
Last Name:PATTERSON
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44986 TRAILS CT
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48187-1754
Mailing Address - Country:US
Mailing Address - Phone:734-329-3648
Mailing Address - Fax:
Practice Address - Street 1:44986 TRAILS CT
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48187-1754
Practice Address - Country:US
Practice Address - Phone:734-329-3648
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-14
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health