Provider Demographics
NPI:1083295992
Name:ELSON, DONNA LYNN
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:LYNN
Last Name:ELSON
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:PO BOX 273
Mailing Address - Street 2:
Mailing Address - City:RUSSELLS POINT
Mailing Address - State:OH
Mailing Address - Zip Code:43348-0273
Mailing Address - Country:US
Mailing Address - Phone:937-935-3064
Mailing Address - Fax:
Practice Address - Street 1:14196 COUNTY ROAD 87
Practice Address - Street 2:
Practice Address - City:LAKEVIEW
Practice Address - State:OH
Practice Address - Zip Code:43331-9400
Practice Address - Country:US
Practice Address - Phone:937-935-3064
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-21
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker