Provider Demographics
NPI:1598400244
Name:LEWIS, PATRICIA LINN (LPN)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:LINN
Last Name:LEWIS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MRS
Other - First Name:PATRICIA
Other - Middle Name:LINN
Other - Last Name:LEWIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPN
Mailing Address - Street 1:6321 SAND HILL CT
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD TWP
Mailing Address - State:OH
Mailing Address - Zip Code:45011-7946
Mailing Address - Country:US
Mailing Address - Phone:513-212-4481
Mailing Address - Fax:
Practice Address - Street 1:6321 SAND HILL CT
Practice Address - Street 2:
Practice Address - City:FAIRFIELD TWP
Practice Address - State:OH
Practice Address - Zip Code:45011-7946
Practice Address - Country:US
Practice Address - Phone:513-212-4481
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-27
Last Update Date:2022-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH143040164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse