Healthcare Provider Details

I. General information

NPI: 1942163092
Provider Name (Legal Business Name): PATRICIA SOUVERAIN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/05/2025
Last Update Date: 12/05/2025
Certification Date: 11/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11327 MELCLARE DR
BELTSVILLE MD
20705-2742
US

IV. Provider business mailing address

1327 MELCLARE DRIVE
BELTSVILLE MD
20705
US

V. Phone/Fax

Practice location:
  • Phone: 240-302-4072
  • Fax:
Mailing address:
  • Phone: 240-302-4072
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: