Provider Demographics
NPI:1902644552
Name:MEZQUITA, PATRICIA LEANDRA (RN)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:LEANDRA
Last Name:MEZQUITA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:62 EXETER ST
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01843-2903
Mailing Address - Country:US
Mailing Address - Phone:978-398-7157
Mailing Address - Fax:
Practice Address - Street 1:1 GRIFFIN BROOK DR
Practice Address - Street 2:
Practice Address - City:METHUEN
Practice Address - State:MA
Practice Address - Zip Code:01844-1865
Practice Address - Country:US
Practice Address - Phone:978-689-6573
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-17
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2389409163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse