Provider Demographics
NPI:1487263760
Name:NATIVIO, PATRICIA ANN (LAT)
Entity type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:ANN
Last Name:NATIVIO
Suffix:
Gender:F
Credentials:LAT
Other - Prefix:
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Mailing Address - Street 1:526 ALABAMA AVE APT C
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21801-5787
Mailing Address - Country:US
Mailing Address - Phone:443-754-5474
Mailing Address - Fax:410-621-3444
Practice Address - Street 1:UNIVERSITY OF MARYLAND UNIVERSITY EASTERN SHORE
Practice Address - Street 2:WILLIAM P HYTCHE ATHLETIC CENTER
Practice Address - City:PRINCESS ANNE
Practice Address - State:MD
Practice Address - Zip Code:21801
Practice Address - Country:US
Practice Address - Phone:410-651-6510
Practice Address - Fax:410-621-3444
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-23
Last Update Date:2020-07-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDA00000022255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic TrainerGroup - Single Specialty