Provider Demographics
NPI:1497216584
Name:LORD, PATRICIA MARIE (RN, BSN, CDE)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:MARIE
Last Name:LORD
Suffix:
Gender:F
Credentials:RN, BSN, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8275 ASHFORD ST
Mailing Address - Street 2:
Mailing Address - City:CONCORD TWP
Mailing Address - State:OH
Mailing Address - Zip Code:44077-9387
Mailing Address - Country:US
Mailing Address - Phone:440-487-5609
Mailing Address - Fax:
Practice Address - Street 1:8275 ASHFORD ST
Practice Address - Street 2:
Practice Address - City:CONCORD TWP
Practice Address - State:OH
Practice Address - Zip Code:44077-9387
Practice Address - Country:US
Practice Address - Phone:440-487-5609
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-29
Last Update Date:2019-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN280973163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator