Provider Demographics
NPI:1316380108
Name:PATTERSON, TRINA (LPN)
Entity type:Individual
Prefix:
First Name:TRINA
Middle Name:
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21900 PRIDAY AVE
Mailing Address - Street 2:
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44123-2675
Mailing Address - Country:US
Mailing Address - Phone:216-482-6366
Mailing Address - Fax:
Practice Address - Street 1:21900 PRIDAY AVE
Practice Address - Street 2:
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44123-2675
Practice Address - Country:US
Practice Address - Phone:216-482-6366
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-10
Last Update Date:2013-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN-140260-M-IV CERT164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse