Provider Demographics
NPI:1285751628
Name:JONES, DONNA MARIE
Entity type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:MARIE
Last Name:JONES
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 1:1116 LONGVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:WEST PORTSMOUTH
Mailing Address - State:OH
Mailing Address - Zip Code:45663-5929
Mailing Address - Country:US
Mailing Address - Phone:740-858-1324
Mailing Address - Fax:740-858-1324
Practice Address - Street 1:1116 LONGVIEW AVE
Practice Address - Street 2:
Practice Address - City:WEST PORTSMOUTH
Practice Address - State:OH
Practice Address - Zip Code:45663-5929
Practice Address - Country:US
Practice Address - Phone:740-858-1324
Practice Address - Fax:740-858-1324
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHT1019376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2551126Medicaid