Provider Demographics
NPI:1285285924
Name:PATRICK, SUKHWEEN KAUR (NURSE PRACTITIONER)
Entity type:Individual
Prefix:
First Name:SUKHWEEN
Middle Name:KAUR
Last Name:PATRICK
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2960 FERNDOWN DR
Mailing Address - Street 2:
Mailing Address - City:MIAMISBURG
Mailing Address - State:OH
Mailing Address - Zip Code:45342-3585
Mailing Address - Country:US
Mailing Address - Phone:937-956-1136
Mailing Address - Fax:937-813-2637
Practice Address - Street 1:2960 FERNDOWN DR
Practice Address - Street 2:
Practice Address - City:MIAMISBURG
Practice Address - State:OH
Practice Address - Zip Code:45342-3585
Practice Address - Country:US
Practice Address - Phone:937-956-1136
Practice Address - Fax:937-813-2637
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-24
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH025590363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily