Provider Demographics
NPI:1285429894
Name:KNISLEY, DONNA
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:KNISLEY
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5218 STATE ROUTE 124
Mailing Address - Street 2:
Mailing Address - City:LATHAM
Mailing Address - State:OH
Mailing Address - Zip Code:45646-9704
Mailing Address - Country:US
Mailing Address - Phone:740-222-4532
Mailing Address - Fax:
Practice Address - Street 1:5218 STATE ROUTE 124
Practice Address - Street 2:
Practice Address - City:LATHAM
Practice Address - State:OH
Practice Address - Zip Code:45646-9704
Practice Address - Country:US
Practice Address - Phone:740-222-4532
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-14
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant