Provider Demographics
NPI:1518244391
Name:DONAVAN, GINGER SKY (LPN)
Entity Type:Individual
Prefix:MRS
First Name:GINGER
Middle Name:SKY
Last Name:DONAVAN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6320 BROWNSVILLE RD SE
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:OH
Mailing Address - Zip Code:43056-9526
Mailing Address - Country:US
Mailing Address - Phone:740-763-4996
Mailing Address - Fax:
Practice Address - Street 1:6320 BROWNSVILLE RD SE
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:OH
Practice Address - Zip Code:43056-9526
Practice Address - Country:US
Practice Address - Phone:740-763-4996
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-08
Last Update Date:2015-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN146576164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse