Individual
DONNA DARLENE POLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
210 N 7TH ST, SUITE 101, MARIETTA, OH 45750-2244
(740) 376-0490
(740) 376-0438
Mailing address
PO BOX 449, MARIETTA, OH 45750-0449
(740) 374-4500
(740) 374-5887
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
COA.08621.NP
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000680677
ANTHEM
OH
01
—
000000699828
ANTHEM
OH
01
—
000000733078
ANTHEM
OH
05
—
2811201
—
OH
05
—
3810018814
—
WV
01
—
P01207861
RAILROAD MEDICARE
OH
Enumeration date
02/23/2007
Last updated
10/14/2013
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