Provider Demographics
NPI:1851632160
Name:GARVER, PATTY ANN (LPN)
Entity Type:Individual
Prefix:
First Name:PATTY
Middle Name:ANN
Last Name:GARVER
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 1:5522 LANCE RD
Mailing Address - Street 2:
Mailing Address - City:MEDINA
Mailing Address - State:OH
Mailing Address - Zip Code:44256-7523
Mailing Address - Country:US
Mailing Address - Phone:330-725-1376
Mailing Address - Fax:
Practice Address - Street 1:5522 LANCE RD
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256-7523
Practice Address - Country:US
Practice Address - Phone:330-725-1376
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-12
Last Update Date:2013-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN069630-MEDS164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse