Provider Demographics
NPI:1043535016
Name:WAID, PATRICIA LYNN (LPN)
Entity type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:LYNN
Last Name:WAID
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MISS
Other - First Name:PATRICIA
Other - Middle Name:LYNN
Other - Last Name:WARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8551 COUNTY ROAD 146
Mailing Address - Street 2:
Mailing Address - City:LODI
Mailing Address - State:NY
Mailing Address - Zip Code:14860-9742
Mailing Address - Country:US
Mailing Address - Phone:607-532-8741
Mailing Address - Fax:
Practice Address - Street 1:8551 COUNTY ROAD 146
Practice Address - Street 2:
Practice Address - City:LODI
Practice Address - State:NY
Practice Address - Zip Code:14860-9742
Practice Address - Country:US
Practice Address - Phone:607-532-8741
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-02
Last Update Date:2010-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY237570-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse