Individual
MS. STACIE LYN PATTERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
13677 W. MC DOWELL ROAD, 201, GOODYEAR, AZ 85395
(623) 882-1926
(623) 882-1709
Mailing address
13677 W. MC DOWELL ROAD, STE 201, GOODYEAR, AZ 85395
(623) 882-1926
(623) 882-1709
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
5601004376
MI
363AS0400X
Surgical Physician Assistant
Primary
AZ 5154
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0F37698
BCBSM
MI
Enumeration date
03/29/2007
Last updated
07/02/2014
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