Provider Demographics
NPI:1295008936
Name:MARCOZZI, PATRICIA SUE (RN)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:SUE
Last Name:MARCOZZI
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 1:3205 OLD CARRIAGE TRL
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:MI
Mailing Address - Zip Code:48116-9432
Mailing Address - Country:US
Mailing Address - Phone:810-225-7439
Mailing Address - Fax:
Practice Address - Street 1:3205 OLD CARRIAGE TRL
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:MI
Practice Address - Zip Code:48116-9432
Practice Address - Country:US
Practice Address - Phone:810-225-7439
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-10
Last Update Date:2012-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704147308163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse