Patty Jo Mattox, C.R.N.P.
Nurse Practitioner in Baltimore, MD. Individual provider (NPI-1).
NPI number1104875293
StatusActive
Last updated in NPPESJan 25, 2013
Details
- NPI
- 1104875293
- Entity type
- Individual (NPI-1)
- Name
- Patty Jo Mattox
- Credential
- C.R.N.P.
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- May 8, 2006
- Last updated
- Jan 25, 2013
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363L00000X | Nurse Practitioner | R146293 | MD | Yes |
Practice location
4940 Eastern AveBaltimore, MD 21224-2735
Phone 410-550-5633
Mailing address
Po Box 64264Baltimore, MD 21264-4264
Phone 410-933-4397
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