MEDICARE: PATRICIA R ALDREDGE NP

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	0024164521	VA

General Provider Information

NPI Number	:	1689908915
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICIA R ALDREDGE NP

Provider Business Mailing Address
First Line	:	2510 GASKINS RD
Second Line	:
City	:	HENRICO
State	:	VA
Zip	:	23238-1481
Country	:	US
Telephone Number	:	804-282-4940
Fax Number	:	804-282-4941

Provider Business Practice Location Address
First Line	:	2510 GASKINS RD
Second Line	:
City	:	HENRICO
State	:	VA
Zip	:	23238-1481
Country	:	US
Telephone Number	:	804-282-4940
Fax Number	:	804-282-4941

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

Provider Enumeration Date	:	09/18/2009
Last Update Date	:	03/18/2015

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