Individual
MRS. GLENDA SUE PATREDIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
5201 HARRY HINES BLVD, DALLAS, TX 75235-7708
(972) 414-1823
Mailing address
PO BOX 660599, DALLAS, TX 75266-0599
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
441738
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
138982701
—
TX
05
—
138982702
—
TX
05
—
138982703
—
TX
05
—
138982704
—
TX
05
—
138982707
—
TX
05
—
138982708
—
TX
05
—
138982710
—
TX
05
—
138982713
—
TX
05
—
138982715
—
TX
05
—
138982716
—
TX
Enumeration date
11/18/2005
Last updated
01/05/2009
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