Provider Demographics
NPI:1336582337
Name:DONOVAN, DANA ANGELA (LPN)
Entity type:Individual
Prefix:MS
First Name:DANA
Middle Name:ANGELA
Last Name:DONOVAN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MISS
Other - First Name:DANA
Other - Middle Name:ANGELA
Other - Last Name:ROMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5943 SR 303
Mailing Address - Street 2:
Mailing Address - City:RAVENNA
Mailing Address - State:OH
Mailing Address - Zip Code:44266-9123
Mailing Address - Country:US
Mailing Address - Phone:216-526-4979
Mailing Address - Fax:
Practice Address - Street 1:5943 SR 303
Practice Address - Street 2:
Practice Address - City:RAVENNA
Practice Address - State:OH
Practice Address - Zip Code:44266-9123
Practice Address - Country:US
Practice Address - Phone:216-526-4979
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-10
Last Update Date:2013-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN. 091269164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse