Provider Demographics
NPI:1972800423
Name:PREDMORE, PATRICIA ELAINE (RN)
Entity type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:ELAINE
Last Name:PREDMORE
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 1:23 WALLINGFORD RISE
Mailing Address - Street 2:
Mailing Address - City:FAIRPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14450-9390
Mailing Address - Country:US
Mailing Address - Phone:585-223-6272
Mailing Address - Fax:
Practice Address - Street 1:23 WALLINGFORD RISE
Practice Address - Street 2:
Practice Address - City:FAIRPORT
Practice Address - State:NY
Practice Address - Zip Code:14450-9390
Practice Address - Country:US
Practice Address - Phone:585-223-6272
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-18
Last Update Date:2011-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY298050163W00000X, 163WC1500X, 163WC1600X, 163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163WC1600XNursing Service ProvidersRegistered NurseContinuing Education/Staff Development
No163WH0200XNursing Service ProvidersRegistered NurseHome Health