Provider Demographics
NPI:1417153396
Name:AMANN, DONALD FRED (RN)
Entity Type:Individual
Prefix:MR
First Name:DONALD
Middle Name:FRED
Last Name:AMANN
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4834 RAEBURN LN
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45223-1230
Mailing Address - Country:US
Mailing Address - Phone:513-541-4066
Mailing Address - Fax:
Practice Address - Street 1:4834 RAEBURN LN
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45223-1230
Practice Address - Country:US
Practice Address - Phone:513-541-4066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN200900163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2525360Medicaid