Provider Demographics
NPI:1619387347
Name:RUE, DONNA ILENE
Entity Type:Individual
Prefix:MS
First Name:DONNA
Middle Name:ILENE
Last Name:RUE
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 1:1786 SARATOGA DR
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:OH
Mailing Address - Zip Code:45373-1642
Mailing Address - Country:US
Mailing Address - Phone:937-451-0660
Mailing Address - Fax:
Practice Address - Street 1:1786 SARATOGA DR
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:OH
Practice Address - Zip Code:45373-1642
Practice Address - Country:US
Practice Address - Phone:937-451-0660
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-02
Last Update Date:2014-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant