Provider Demographics
NPI:1144956244
Name:GADSON, PATRICE DICIE PEARL
Entity type:Individual
Prefix:
First Name:PATRICE
Middle Name:DICIE PEARL
Last Name:GADSON
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 1:1299 ORLANDO AVE
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44320-3456
Mailing Address - Country:US
Mailing Address - Phone:480-547-6468
Mailing Address - Fax:
Practice Address - Street 1:1299 ORLANDO AVE
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44320-3456
Practice Address - Country:US
Practice Address - Phone:480-547-6468
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-29
Last Update Date:2022-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH400812140908374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide