Provider Demographics
NPI:1447933759
Name:CARRICO, PATRICK LOUIS
Entity type:Individual
Prefix:
First Name:PATRICK
Middle Name:LOUIS
Last Name:CARRICO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:805 LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:SITKA
Mailing Address - State:AK
Mailing Address - Zip Code:99835-7651
Mailing Address - Country:US
Mailing Address - Phone:907-758-9939
Mailing Address - Fax:
Practice Address - Street 1:805 LINCOLN ST
Practice Address - Street 2:
Practice Address - City:SITKA
Practice Address - State:AK
Practice Address - Zip Code:99835-7651
Practice Address - Country:US
Practice Address - Phone:907-758-9939
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-11
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker