Provider Demographics
NPI:1023765997
Name:BACCHUS, PATRICIA A (RN)
Entity type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:A
Last Name:BACCHUS
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 1:10656 CHELMSFORD RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45240-3910
Mailing Address - Country:US
Mailing Address - Phone:513-674-0133
Mailing Address - Fax:
Practice Address - Street 1:10656 CHELMSFORD RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45240-3910
Practice Address - Country:US
Practice Address - Phone:513-674-0133
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-09
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child