Provider Demographics
NPI:1376858399
Name:PRATT, DONNA SUE (LPN)
Entity Type:Individual
Prefix:MS
First Name:DONNA
Middle Name:SUE
Last Name:PRATT
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 1:6242 LAKE AVE
Mailing Address - Street 2:
Mailing Address - City:ELYRIA
Mailing Address - State:OH
Mailing Address - Zip Code:44035-1022
Mailing Address - Country:US
Mailing Address - Phone:440-324-6242
Mailing Address - Fax:
Practice Address - Street 1:6242 LAKE AVE
Practice Address - Street 2:
Practice Address - City:ELYRIA
Practice Address - State:OH
Practice Address - Zip Code:44035-1022
Practice Address - Country:US
Practice Address - Phone:440-324-6242
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-13
Last Update Date:2010-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN 077090164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse