Provider Demographics
NPI:1922024561
Name:PATTAVINA, MARIA ANTOINETTE (APRN)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:ANTOINETTE
Last Name:PATTAVINA
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:571 S ALLEN RD
Mailing Address - Street 2:
Mailing Address - City:FLAT ROCK
Mailing Address - State:NC
Mailing Address - Zip Code:28731-9447
Mailing Address - Country:US
Mailing Address - Phone:828-692-6178
Mailing Address - Fax:828-692-2365
Practice Address - Street 1:571 S ALLEN RD
Practice Address - Street 2:
Practice Address - City:FLAT ROCK
Practice Address - State:NC
Practice Address - Zip Code:28731-9447
Practice Address - Country:US
Practice Address - Phone:828-692-6178
Practice Address - Fax:828-692-2365
Is Sole Proprietor?:No
Enumeration Date:2006-07-15
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRNJ11021984363LF0000X
NH0408652303363LF0000X
NC5014417363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30009295Medicaid
S47221Medicare UPIN
NH30009295Medicaid