Provider Demographics
NPI:1366605669
Name:WOODMAN, PATRICIA DALE (LPN)
Entity type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:DALE
Last Name:WOODMAN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 HIGHCREST PARK
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:MA
Mailing Address - Zip Code:01570-4358
Mailing Address - Country:US
Mailing Address - Phone:508-943-1975
Mailing Address - Fax:
Practice Address - Street 1:34 HIGHCREST PARK
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:MA
Practice Address - Zip Code:01570-4358
Practice Address - Country:US
Practice Address - Phone:508-943-1975
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-07
Last Update Date:2008-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA40121164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse