Provider Demographics
NPI:1821487422
Name:LOUIS, PATRICIA (LPN)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:LOUIS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22919 EDGEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:LAURELTON
Mailing Address - State:NY
Mailing Address - Zip Code:11413-3637
Mailing Address - Country:US
Mailing Address - Phone:347-484-0142
Mailing Address - Fax:
Practice Address - Street 1:22919 EDGEWOOD AVE
Practice Address - Street 2:
Practice Address - City:LAURELTON
Practice Address - State:NY
Practice Address - Zip Code:11413-3637
Practice Address - Country:US
Practice Address - Phone:347-484-0142
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-20
Last Update Date:2015-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY311463-1251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care