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Individual

CORTNIE L PATTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
1721 MAGNAVOX, FORT WAYNE, IN 46804-1537
(260) 748-3650
(260) 748-3651
Mailing address
7619 W JEFFERSON BLVD, FORT WAYNE, IN 46804-4133
(260) 407-8000

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28225685A
IN
363L00000X
Nurse Practitioner
Primary
71009770A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
300035248
IN
Enumeration date
09/24/2019
Last updated
01/07/2022
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