MEDICARE: MS. KRISTEN NOELLE PATRICK

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	253Z00000X	In Home Supportive Care Agency
2	376J00000X	Homemaker
3	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1932841228
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KRISTEN NOELLE PATRICK

Provider Business Mailing Address
First Line	:	1414 CAROLINA AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45237-5616
Country	:	US
Telephone Number	:	513-888-3796
Fax Number	:

Provider Business Practice Location Address
First Line	:	1414 CAROLINA AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45237-5616
Country	:	US
Telephone Number	:	513-888-3796
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/08/2022
Last Update Date	:	04/08/2022

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