Provider Demographics
NPI:1073730230
Name:YODER, PATRICIA S (RN)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:S
Last Name:YODER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 WESTTOWN ROAD
Mailing Address - Street 2:SUITE 180
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19380-0990
Mailing Address - Country:US
Mailing Address - Phone:610-344-6459
Mailing Address - Fax:610-344-6727
Practice Address - Street 1:601 WESTTOWN ROAD
Practice Address - Street 2:SUITE 180
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19380-0990
Practice Address - Country:US
Practice Address - Phone:610-344-6459
Practice Address - Fax:610-344-6727
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN285618L163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1016254850001Medicaid