Provider Demographics
NPI:1497967319
Name:MCDONALD, BILLIE JO
Entity Type:Individual
Prefix:
First Name:BILLIE
Middle Name:JO
Last Name:MCDONALD
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 1:8387 REFORM RD
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:OH
Mailing Address - Zip Code:43055-9126
Mailing Address - Country:US
Mailing Address - Phone:740-745-5119
Mailing Address - Fax:
Practice Address - Street 1:8387 REFORM RD
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:OH
Practice Address - Zip Code:43055-9126
Practice Address - Country:US
Practice Address - Phone:740-745-5119
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2554767OtherINDEPENDENT PROVIDER