Provider Demographics
NPI:1376050161
Name:OLIVER, DONNA MARIE (CNP)
Entity Type:Individual
Prefix:MS
First Name:DONNA
Middle Name:MARIE
Last Name:OLIVER
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:DONNA
Other - Middle Name:MARIE
Other - Last Name:JASIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4973 BROOKSDALE RD
Mailing Address - Street 2:
Mailing Address - City:MENTOR
Mailing Address - State:OH
Mailing Address - Zip Code:44060-1240
Mailing Address - Country:US
Mailing Address - Phone:216-312-5490
Mailing Address - Fax:
Practice Address - Street 1:9500 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44195-0001
Practice Address - Country:US
Practice Address - Phone:216-444-2200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-03
Last Update Date:2018-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.022139363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily