Provider Demographics
NPI:1366047672
Name:MALONE, PATRICIA A
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:A
Last Name:MALONE
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 1:2118 S TOWNSHIP ROAD 119
Mailing Address - Street 2:
Mailing Address - City:TIFFIN
Mailing Address - State:OH
Mailing Address - Zip Code:44883-9764
Mailing Address - Country:US
Mailing Address - Phone:419-937-7432
Mailing Address - Fax:
Practice Address - Street 1:2118 S TOWNSHIP ROAD 119
Practice Address - Street 2:
Practice Address - City:TIFFIN
Practice Address - State:OH
Practice Address - Zip Code:44883-9764
Practice Address - Country:US
Practice Address - Phone:419-937-7432
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-03
Last Update Date:2020-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker