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Individual

DONETTA HARRISON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
7164 BROOKE BLVE., REYNOLDSBURG, OH 43068
(614) 495-7489
Mailing address
7164 BROOKE BLVE., REYNOLDSBURG, OH 43068
(614) 495-7489

Taxonomy

Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
401233670511
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
401233670511
OH
Enumeration date
11/21/2022
Last updated
11/21/2022
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