Provider Demographics
NPI:1861138281
Name:PATTERSON, AUDREY NOEL (BA)
Entity type:Individual
Prefix:
First Name:AUDREY
Middle Name:NOEL
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4675 FORDHAM CIR
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301-4129
Mailing Address - Country:US
Mailing Address - Phone:708-674-5396
Mailing Address - Fax:
Practice Address - Street 1:2627 REDWING RD STE 250
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80526-6329
Practice Address - Country:US
Practice Address - Phone:970-430-5520
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-09
Last Update Date:2022-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program