Provider Demographics
NPI:1447809975
Name:PATCH, MARIE ELAINE
Entity type:Individual
Prefix:
First Name:MARIE
Middle Name:ELAINE
Last Name:PATCH
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 1:7 SUMMER ST
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:NH
Mailing Address - Zip Code:03835-3702
Mailing Address - Country:US
Mailing Address - Phone:603-839-1095
Mailing Address - Fax:
Practice Address - Street 1:7 SUMMER ST
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:NH
Practice Address - Zip Code:03835-3702
Practice Address - Country:US
Practice Address - Phone:603-839-1095
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-07
Last Update Date:2019-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider