Provider Demographics
NPI:1184286205
Name:SANDERS-ROSEMAN, PATRIKA (RN)
Entity type:Individual
Prefix:
First Name:PATRIKA
Middle Name:
Last Name:SANDERS-ROSEMAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5879 TAYLORSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45424-2671
Mailing Address - Country:US
Mailing Address - Phone:937-270-0611
Mailing Address - Fax:
Practice Address - Street 1:5879 TAYLORSVILLE RD
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45424-2671
Practice Address - Country:US
Practice Address - Phone:937-270-0611
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-28
Last Update Date:2019-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN462605163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse