Individual
NANCY ANN PATTISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
100 CHERRY ST SE, GRAND RAPIDS, MI 49503-4526
(616) 965-8200
Mailing address
100 CHERRY ST SE, GRAND RAPIDS, MI 49503-4526
(616) 965-8200
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
4301069203
MI
2084P0800X
Psychiatry Physician
4301069203
MI
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
4301069203
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
133795
AMERICAN ACADEMY OF PEDIA
—
05
—
3486280
—
MI
Enumeration date
05/02/2007
Last updated
10/29/2014
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