Individual
TEENA PATTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1549 BELLEMEADE DR, MAYFIELD, KY 42066-3723
(270) 251-0079
(270) 251-0079
Mailing address
1549 BELLEMEADE DR, MAYFIELD, KY 42066-3723
(270) 251-0079
(270) 251-0079
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1091722
KY
367500000X
Certified Registered Nurse Anesthetist
R26522
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
74001298
—
KY
Enumeration date
06/20/2006
Last updated
07/08/2007
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