Provider Demographics
NPI:1952528085
Name:PATCH, DONNA LEE (LD, RDN)
Entity Type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:LEE
Last Name:PATCH
Suffix:
Gender:F
Credentials:LD, RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 FOUNDRY ST STE 101
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-5421
Mailing Address - Country:US
Mailing Address - Phone:603-230-5636
Mailing Address - Fax:603-227-7584
Practice Address - Street 1:18 FOUNDRY ST STE 201
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-5421
Practice Address - Country:US
Practice Address - Phone:603-230-5636
Practice Address - Fax:603-227-7584
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH76133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
HP1529119-01OtherHP