Basic Information
| Provider Information | |||||||||
| NPI: | 1619479920 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PATTERSON | ||||||||
| FirstName: | MICHELLE | ||||||||
| MiddleName: | CELINE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1618 MONROE ST NW | ||||||||
| Address2: | |||||||||
| City: | WASHINGTON | ||||||||
| State: | DC | ||||||||
| PostalCode: | 200101804 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2029392400 | ||||||||
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| Practice Location | |||||||||
| Address1: | 601 NEW JERSEY AVE NW STE 200 | ||||||||
| Address2: | |||||||||
| City: | WASHINGTON | ||||||||
| State: | DC | ||||||||
| PostalCode: | 200013030 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2022047092 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/02/2018 | ||||||||
| LastUpdateDate: | 10/05/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/05/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | RN1028162 | DC | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.