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Individual

MRS. PEPPER PATTERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
1501 KINGS HIGHWAY, SHREVEPORT, LA 71103-4228
(318) 675-5581
Mailing address
P O BOX 5310, SHREVEPORT, LA 71135
(318) 675-5584
(318) 675-6681

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
AP04403
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1478504
LA
05
190679401
TX
Enumeration date
09/20/2006
Last updated
02/25/2011
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