Provider Demographics
NPI:1285453035
Name:CODY, PATRICIA (PMHNP)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:CODY
Suffix:
Gender:
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 84
Mailing Address - Street 2:1632 SINGLEY LANE
Mailing Address - City:UPPER BLACK EDDY
Mailing Address - State:PA
Mailing Address - Zip Code:18972
Mailing Address - Country:US
Mailing Address - Phone:215-534-3723
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 84
Practice Address - Street 2:1632 SINGLEY LANE
Practice Address - City:UPPER BLACK EDDY
Practice Address - State:PA
Practice Address - Zip Code:18972
Practice Address - Country:US
Practice Address - Phone:215-534-3723
Practice Address - Fax:551-361-9199
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-08
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ15150100363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health