Provider Demographics
NPI:1861806648
Name:PATTON, JANE (EDD, OTR/L, FAOTA)
Entity type:Individual
Prefix:
First Name:JANE
Middle Name:
Last Name:PATTON
Suffix:
Gender:F
Credentials:EDD, OTR/L, FAOTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 HEART DR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-8982
Mailing Address - Country:US
Mailing Address - Phone:252-744-2045
Mailing Address - Fax:252-744-3194
Practice Address - Street 1:101 HEART DR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-8982
Practice Address - Country:US
Practice Address - Phone:252-744-2045
Practice Address - Fax:252-744-3194
Is Sole Proprietor?:No
Enumeration Date:2014-06-19
Last Update Date:2014-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0666225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist