Individual
MS. MARILYN M. PATTILLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN GNP
Contact information
Practice address
3509 ROGGE LN, AUSTIN, TX 78723-3640
(512) 926-2070
(512) 926-9570
Mailing address
1700 JACKSON HOLE CV, AUSTIN, TX 78746-7634
(512) 451-4488
(512) 453-2707
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
424864
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NP7217
BLUE CROSS PROVIDER NUMBE
TX
Enumeration date
04/03/2006
Last updated
07/21/2022
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