Provider Demographics
NPI:1053622233
Name:JARVIS, PATRICIA S (RN)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:S
Last Name:JARVIS
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 1:13344 MCCONNELLSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:CALDWELL
Mailing Address - State:OH
Mailing Address - Zip Code:43724-9699
Mailing Address - Country:US
Mailing Address - Phone:740-732-4395
Mailing Address - Fax:
Practice Address - Street 1:43 KENNEDY DR
Practice Address - Street 2:
Practice Address - City:CALDWELL
Practice Address - State:OH
Practice Address - Zip Code:43724-9004
Practice Address - Country:US
Practice Address - Phone:740-732-5211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-23
Last Update Date:2010-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN342915163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse