Provider Demographics
NPI:1326259441
Name:KUSIOR, DONNA (LPN)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:KUSIOR
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48492 STATE ROUTE 14
Mailing Address - Street 2:
Mailing Address - City:NEW WATERFORD
Mailing Address - State:OH
Mailing Address - Zip Code:44445-9733
Mailing Address - Country:US
Mailing Address - Phone:330-457-0069
Mailing Address - Fax:
Practice Address - Street 1:420 YOUNGSTOWN POLAND RD
Practice Address - Street 2:
Practice Address - City:STRUTHERS
Practice Address - State:OH
Practice Address - Zip Code:44471-1058
Practice Address - Country:US
Practice Address - Phone:330-755-2147
Practice Address - Fax:330-755-2846
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH071471164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse