Provider Demographics
NPI:1699364521
Name:FURR, DOROTHEA
Entity type:Individual
Prefix:
First Name:DOROTHEA
Middle Name:
Last Name:FURR
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 1:8158 BARBERRY HILL DR
Mailing Address - Street 2:
Mailing Address - City:MENTOR
Mailing Address - State:OH
Mailing Address - Zip Code:44060-5646
Mailing Address - Country:US
Mailing Address - Phone:216-533-3839
Mailing Address - Fax:
Practice Address - Street 1:8158 BARBERRY HILL DR
Practice Address - Street 2:
Practice Address - City:MENTOR
Practice Address - State:OH
Practice Address - Zip Code:44060-5646
Practice Address - Country:US
Practice Address - Phone:216-533-3839
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-14
Last Update Date:2021-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH104857149999376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker