Individual
DARLENE PATTERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8503 178TH LN NE, FOREST LAKE, MN 55025-8351
(651) 464-6167
Mailing address
PO BOX 34, CHISAGO CITY, MN 55013-0034
(612) 749-4176
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
84Z92LI
BLUECROSS BLUESHIELD
MN
Enumeration date
06/09/2010
Last updated
06/09/2010
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