Provider Demographics
NPI:1528818978
Name:PATTEN, CAROLINE ELIZABETH (FNP)
Entity type:Individual
Prefix:
First Name:CAROLINE
Middle Name:ELIZABETH
Last Name:PATTEN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:825 BENNETT AVE
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-6715
Mailing Address - Country:US
Mailing Address - Phone:541-779-5228
Mailing Address - Fax:541-772-1533
Practice Address - Street 1:825 BENNETT AVE
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-6715
Practice Address - Country:US
Practice Address - Phone:541-779-5228
Practice Address - Fax:541-772-1533
Is Sole Proprietor?:No
Enumeration Date:2024-03-26
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR202008879RN163W00000X
OR10024625363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse