Provider Demographics
NPI:1063133817
Name:DONNELL, SHARON MARIE
Entity type:Individual
Prefix:MS
First Name:SHARON
Middle Name:MARIE
Last Name:DONNELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:143 SQUIRREL RD
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45405-4444
Mailing Address - Country:US
Mailing Address - Phone:937-223-3240
Mailing Address - Fax:
Practice Address - Street 1:143 SQUIRREL RD
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45405-4444
Practice Address - Country:US
Practice Address - Phone:937-223-3240
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-09
Last Update Date:2022-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH372500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes372500000XNursing Service Related ProvidersChore ProviderGroup - Single Specialty