Provider Demographics
NPI:1457025363
Name:HINES, DONNA LYNN
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:LYNN
Last Name:HINES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4800 CLAGUE RD NORTHOLMSTAD 44070
Mailing Address - Street 2:241E156STAPT1
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44110
Mailing Address - Country:US
Mailing Address - Phone:216-894-1174
Mailing Address - Fax:
Practice Address - Street 1:241 E 156TH ST APT 1241E156
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44110-1352
Practice Address - Country:US
Practice Address - Phone:216-894-1174
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-04
Last Update Date:2021-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty