Provider Demographics
NPI:1013504554
Name:FAIRCHILD, PATRICIA ANN
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:ANN
Last Name:FAIRCHILD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28235 CREOLA CEMETERY RD
Mailing Address - Street 2:
Mailing Address - City:CREOLA
Mailing Address - State:OH
Mailing Address - Zip Code:45622-8910
Mailing Address - Country:US
Mailing Address - Phone:740-270-2739
Mailing Address - Fax:
Practice Address - Street 1:28235 CREOLA CEMETERY RD
Practice Address - Street 2:
Practice Address - City:CREOLA
Practice Address - State:OH
Practice Address - Zip Code:45622-8910
Practice Address - Country:US
Practice Address - Phone:740-270-2738
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-30
Last Update Date:2020-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
No172A00000XOther Service ProvidersDriver
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant