Provider Demographics
NPI:1144960774
Name:PATTERSON, CHRISTINA ISABELLE (BS/RDH)
Entity type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:ISABELLE
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:BS/RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 59019
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37950-9019
Mailing Address - Country:US
Mailing Address - Phone:865-335-6418
Mailing Address - Fax:
Practice Address - Street 1:1914 WALNUT AVE
Practice Address - Street 2:
Practice Address - City:JEFFERSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37760-1704
Practice Address - Country:US
Practice Address - Phone:865-335-6418
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-31
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000003497124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist