Provider Demographics
NPI:1194091181
Name:GILES, DONNA LENORA (LPN)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:LENORA
Last Name:GILES
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3603 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23803-2443
Mailing Address - Country:US
Mailing Address - Phone:804-922-0089
Mailing Address - Fax:
Practice Address - Street 1:3603 MAIN ST
Practice Address - Street 2:
Practice Address - City:SOUTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23803-2443
Practice Address - Country:US
Practice Address - Phone:804-922-0089
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-24
Last Update Date:2012-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0002072058164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse