Ruth Patterson, PNP

Individual provider Active NPI Pediatric Nurse Practitioner · Rustburg, VA

NPI 1285697359 · NPPES record last updated Feb 13, 2020

Key facts

NPI
1285697359
Entity type
Individual (NPI type 1)
Primary specialty
Pediatric Nurse Practitioner 363LP0200X
License
80369 (CO)
Practice address
925 Village Hwy
Rustburg, VA 24588-4591
Phone
(434) 455-2480
NPI assigned
Apr 10, 2006
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
80369COMDPediatric Nurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 80369 CO Yes

Addresses

Primary practice location

925 Village Hwy
Rustburg, VA 24588-4591

Mailing address

134 Elon Rd
Madison Heights, VA 24572-2536
Phone (434) 455-2480

Other practice location 1

3405 Downing St
Denver, CO 80205-3972
Phone (303) 296-1767

Other practice location 2

2402 Atherholt Rd
Lynchburg, VA 24501-2148
Phone (434) 455-2480

Other identifiers

IdentifierTypeStateIssuer
07803695MedicaidCO

Other providers in Rustburg, VA

All providers in Rustburg, VA · Pediatric Nurse Practitioner in Virginia

Sources for this page

Verify at the official NPI Registry.