Provider Demographics
NPI:1447935317
Name:AUSTIN, PATRICIA A
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:A
Last Name:AUSTIN
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 1:1237 DAVIS DR
Mailing Address - Street 2:
Mailing Address - City:FAIRBORN
Mailing Address - State:OH
Mailing Address - Zip Code:45324-5615
Mailing Address - Country:US
Mailing Address - Phone:937-715-2022
Mailing Address - Fax:
Practice Address - Street 1:1237 DAVIS DR
Practice Address - Street 2:
Practice Address - City:FAIRBORN
Practice Address - State:OH
Practice Address - Zip Code:45324-5615
Practice Address - Country:US
Practice Address - Phone:937-715-2022
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-19
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant