Provider Demographics
NPI:1366796526
Name:DONALDSON, RUTH ELAINE (APN)
Entity type:Individual
Prefix:MS
First Name:RUTH
Middle Name:ELAINE
Last Name:DONALDSON
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3118 TRENTWOOD RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43221-2351
Mailing Address - Country:US
Mailing Address - Phone:614-442-6789
Mailing Address - Fax:
Practice Address - Street 1:1479 COLLINS AVE
Practice Address - Street 2:RILEY BUILDING
Practice Address - City:MARYSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43040-8808
Practice Address - Country:US
Practice Address - Phone:937-642-1065
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-08
Last Update Date:2012-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN126895364SP0809X
OHRX 01890364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHDONS03081OtherMEDICARE
OH2655149Medicaid