Provider Demographics
NPI:1891409702
Name:TODD, PATRICIA M (DNP, APRN, PCNSBC)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:M
Last Name:TODD
Suffix:
Gender:F
Credentials:DNP, APRN, PCNSBC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11817 DECOUR CT
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-5822
Mailing Address - Country:US
Mailing Address - Phone:703-424-8573
Mailing Address - Fax:
Practice Address - Street 1:11817 DECOUR CT
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-5822
Practice Address - Country:US
Practice Address - Phone:703-424-8573
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-06
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA00241182005364SP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPediatrics