Provider Demographics
NPI:1982400248
Name:STRADLEY, PATRICIA LYNN
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:LYNN
Last Name:STRADLEY
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5400 W WAVERLY RD
Mailing Address - Street 2:
Mailing Address - City:RAYMOND
Mailing Address - State:NE
Mailing Address - Zip Code:68428-4264
Mailing Address - Country:US
Mailing Address - Phone:402-525-8981
Mailing Address - Fax:
Practice Address - Street 1:5400 W WAVERLY RD
Practice Address - Street 2:
Practice Address - City:RAYMOND
Practice Address - State:NE
Practice Address - Zip Code:68428-4264
Practice Address - Country:US
Practice Address - Phone:402-525-8981
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-19
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant