Provider Demographics
NPI:1508590506
Name:WHITESELL, DONNA MARIE (LPN)
Entity Type:Individual
Prefix:MISS
First Name:DONNA
Middle Name:MARIE
Last Name:WHITESELL
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MISS
Other - First Name:DONNA
Other - Middle Name:MARIE
Other - Last Name:WHITESELL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPN
Mailing Address - Street 1:793 OLD ROUTE 119 HWY NORTH
Mailing Address - Street 2:
Mailing Address - City:INDIANA
Mailing Address - State:PA
Mailing Address - Zip Code:15701
Mailing Address - Country:US
Mailing Address - Phone:724-465-5576
Mailing Address - Fax:
Practice Address - Street 1:200 PRUSHNOK DRIVE
Practice Address - Street 2:
Practice Address - City:PUNXSUTAWNEY
Practice Address - State:PA
Practice Address - Zip Code:15767
Practice Address - Country:US
Practice Address - Phone:814-938-4444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-14
Last Update Date:2022-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPN254593L164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse