Provider Demographics
NPI:1417134313
Name:LAUGHLIN, DONNA R (CNS)
Entity Type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:R
Last Name:LAUGHLIN
Suffix:
Gender:F
Credentials:CNS
Other - Prefix:
Other - First Name:DONNA
Other - Middle Name:R
Other - Last Name:HARRISON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:63 BAKER BLVD.
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44333-3601
Mailing Address - Country:US
Mailing Address - Phone:330-864-6331
Mailing Address - Fax:330-572-0639
Practice Address - Street 1:63 BAKER BLVD.
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44333-3601
Practice Address - Country:US
Practice Address - Phone:330-864-6331
Practice Address - Fax:330-572-0639
Is Sole Proprietor?:No
Enumeration Date:2008-01-23
Last Update Date:2010-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNS-09729364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0464135Medicaid
OHLANS04011Medicare PIN