Provider Demographics
NPI:1356849863
Name:THOERNER, DONNA ANN (LPN)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:ANN
Last Name:THOERNER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2092 TARRAGON DR
Mailing Address - Street 2:
Mailing Address - City:WEST SALEM
Mailing Address - State:OH
Mailing Address - Zip Code:44287-9195
Mailing Address - Country:US
Mailing Address - Phone:419-651-1264
Mailing Address - Fax:
Practice Address - Street 1:4074 HAMILTON RD
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256-9086
Practice Address - Country:US
Practice Address - Phone:419-651-1264
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-30
Last Update Date:2018-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH126110164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse