Provider Demographics
NPI:1144200254
Name:TODD, PATRICIA ANN (ANP)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:ANN
Last Name:TODD
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CC004 SUNY CANTON
Mailing Address - Street 2:DAVIS HEALTH CENTER
Mailing Address - City:CANTON
Mailing Address - State:NY
Mailing Address - Zip Code:13617-1098
Mailing Address - Country:US
Mailing Address - Phone:315-386-7333
Mailing Address - Fax:315-386-7932
Practice Address - Street 1:CC004 SUNY CANTON
Practice Address - Street 2:DAVIS HEALTH CENTER
Practice Address - City:CANTON
Practice Address - State:NY
Practice Address - Zip Code:13617-1098
Practice Address - Country:US
Practice Address - Phone:315-386-7333
Practice Address - Fax:315-386-7932
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-17
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY30301001363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0198615OtherDEA