Kim L Patterson, RN MSN CPNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

816507 Issued in NV

Practice address

4700 Las Vegas Blvd N
Nellis Afb, NV 89191-6600

Phone

(702) 653-3116

NPI assigned

Jul 18, 2008

Reactivated

May 22, 2012

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Pediatric Nurse Practitioner, Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1216339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555891200000",
    "number": "1699939611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 LAS VEGAS BLVD N",
            "city": "NELLIS AFB",
            "state": "NV",
            "postal_code": "891916600",
            "telephone_number": "702-653-3116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 LAS VEGAS BLVD N",
            "city": "NELLIS AFB",
            "state": "NV",
            "postal_code": "891916600",
            "telephone_number": "702-653-3116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATTERSON",
        "first_name": "KIM",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "RN MSN CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-18",
        "last_updated": "2019-04-22",
        "deactivation_date": "2011-12-21",
        "reactivation_date": "2012-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NV",
            "license": "816507",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dana Parks
• Joshua Ef Pascoe, DO
• Dipti S Patel, DO
• Mayank Patel, M.D.
• Kenneth Russell Patterson, PA-C
• Sierra Lytera Nicole Payton, CNM
• Rexford R Pearce, M.D.
• Gary A. Peitzmeier, M.D.
• Martin Perez Coreas
• Victor Perri Jr., PHARM.D

• Pediatric Nurse Practitioner in Nellis Afb, NV
• Providers in Nellis Afb, NV by specialty
• Pediatric Nurse Practitioner in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.