Provider Demographics
NPI:1598490757
Name:NELSON, DONNA MICHELLE
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:MICHELLE
Last Name:NELSON
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 1:2628 KULL RD
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:OH
Mailing Address - Zip Code:43130-7707
Mailing Address - Country:US
Mailing Address - Phone:614-368-9168
Mailing Address - Fax:
Practice Address - Street 1:2628 KULL RD
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130-7707
Practice Address - Country:US
Practice Address - Phone:614-368-9168
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)