Provider Demographics
NPI:1174120554
Name:PATRICK, HELENA LELAVON
Entity type:Individual
Prefix:
First Name:HELENA
Middle Name:LELAVON
Last Name:PATRICK
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 1:9314 DAVIDS RD
Mailing Address - Street 2:
Mailing Address - City:SABINA
Mailing Address - State:OH
Mailing Address - Zip Code:45169-9377
Mailing Address - Country:US
Mailing Address - Phone:193-736-6766
Mailing Address - Fax:
Practice Address - Street 1:9314 DAVIDS RD
Practice Address - Street 2:
Practice Address - City:SABINA
Practice Address - State:OH
Practice Address - Zip Code:45169-9377
Practice Address - Country:US
Practice Address - Phone:193-736-6766
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-08
Last Update Date:2020-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker