Provider Demographics
NPI:1235216516
Name:PATRICK, NANCY ELIZABETH (PT)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:ELIZABETH
Last Name:PATRICK
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:NANCY
Other - Middle Name:ELIZABETH
Other - Last Name:MCCLAIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:9101 MIDLOTHIAN TPKE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23235-5022
Mailing Address - Country:US
Mailing Address - Phone:804-272-9192
Mailing Address - Fax:
Practice Address - Street 1:9101 MIDLOTHIAN TPKE
Practice Address - Street 2:SUITE 200
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23235-5022
Practice Address - Country:US
Practice Address - Phone:804-272-9192
Practice Address - Fax:804-272-9257
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2008-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305006719225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA013957M74Medicare PIN