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General NPI Number Information
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NPI Number | 1255790317
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Entity Type | Individual
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Provider Name | PATTY ROOF FNP-C
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Gender | Female
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Dates
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Enumeration Date | 02/17/2016
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Last Update Date | 09/10/2018
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Provider Practice Location Address
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Address Line | 771 RIDGEWOOD DR
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City | COSHOCTON
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State | OH
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Zip | 43812
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Country | US
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Telephone | 740-552-1699
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Fax |
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Provider Business Mailing Address
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Address Line | 771 RIDGEWOOD DR
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City | COSHOCTON
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State | OH
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Zip | 43812-2749
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Country | US
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Telephone | 740-552-1699
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APRN.CNP.18492
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License Number State | OH
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