Provider Demographics
NPI:1225527393
Name:BYRD, PATRICIA (NA)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:BYRD
Suffix:
Gender:F
Credentials:NA
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:
Other - Last Name:BYRD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NA
Mailing Address - Street 1:1123 16TH ST NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20002-2901
Mailing Address - Country:US
Mailing Address - Phone:202-424-8671
Mailing Address - Fax:
Practice Address - Street 1:1123 16TH ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-2901
Practice Address - Country:US
Practice Address - Phone:202-424-8671
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-04
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCNA3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NAOtherNA
DCNAOtherNA