Provider Demographics
NPI:1972201945
Name:DONOUGHE, RILEY N
Entity type:Individual
Prefix:
First Name:RILEY
Middle Name:N
Last Name:DONOUGHE
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 1:4550 PIMLICO CIR
Mailing Address - Street 2:
Mailing Address - City:MEDINA
Mailing Address - State:OH
Mailing Address - Zip Code:44256-6343
Mailing Address - Country:US
Mailing Address - Phone:330-461-6820
Mailing Address - Fax:
Practice Address - Street 1:4550 PIMLICO CIR
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256-6343
Practice Address - Country:US
Practice Address - Phone:330-461-6820
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-20
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker