Provider Demographics
NPI:1639684012
Name:ADKINS, PATRICIA SUE (PCA)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:SUE
Last Name:ADKINS
Suffix:
Gender:F
Credentials:PCA
Other - Prefix:MS
Other - First Name:PATRICIA
Other - Middle Name:SUE
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:881 TOMS CRK RD
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:WV
Mailing Address - Zip Code:25570
Mailing Address - Country:US
Mailing Address - Phone:304-356-4562
Mailing Address - Fax:304-558-4563
Practice Address - Street 1:881 TOMS CRK RD
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:WV
Practice Address - Zip Code:25570
Practice Address - Country:US
Practice Address - Phone:304-962-1210
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-07
Last Update Date:2017-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
Provider Identifiers
StateIdentifier IDID TypeIssuer
3810028243OtherPROVIDER ID