Provider Demographics
NPI:1477911055
Name:ATKINSON -SMITH, PATRICKA S
Entity Type:Individual
Prefix:MRS
First Name:PATRICKA
Middle Name:S
Last Name:ATKINSON -SMITH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:PATRICKA
Other - Middle Name:
Other - Last Name:ATKINSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:18 LAWRENCE ST
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10977-5038
Mailing Address - Country:US
Mailing Address - Phone:845-596-4651
Mailing Address - Fax:
Practice Address - Street 1:18 LAWRENCE ST
Practice Address - Street 2:
Practice Address - City:SPRING VALLEY
Practice Address - State:NY
Practice Address - Zip Code:10977-5038
Practice Address - Country:US
Practice Address - Phone:184-559-6465
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-10
Last Update Date:2017-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2640921164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse