Provider Demographics
NPI:1922233584
Name:TOLBERT, PATRICIA RENEE (LPN)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:RENEE
Last Name:TOLBERT
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:RENEE
Other - Last Name:TOLBERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:257 N WINTON RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14610-1230
Mailing Address - Country:US
Mailing Address - Phone:585-627-3056
Mailing Address - Fax:
Practice Address - Street 1:257 NORTH WINTON ROAD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14610
Practice Address - Country:US
Practice Address - Phone:585-627-3056
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-26
Last Update Date:2014-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY241551-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse