Individual
SUZANNE M PATTISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
10515 ILLINOIS RD, FORT WAYNE, IN 46814-9182
(260) 373-9233
(260) 373-9219
Mailing address
1234 E DUPONT RD, SUITE 3, FORT WAYNE, IN 46825-1545
(260) 373-9965
(260) 458-5664
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
37001826A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000639752
ANTHEM
IN
Enumeration date
11/30/2009
Last updated
02/25/2010
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