Provider Demographics
NPI:1639826134
Name:OATES, DAUNITTA MARIE
Entity Type:Individual
Prefix:
First Name:DAUNITTA
Middle Name:MARIE
Last Name:OATES
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 1:14729 STATE RD
Mailing Address - Street 2:
Mailing Address - City:OSTRANDER
Mailing Address - State:OH
Mailing Address - Zip Code:43061-9508
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:14729 STATE RD
Practice Address - Street 2:
Practice Address - City:OSTRANDER
Practice Address - State:OH
Practice Address - Zip Code:43061-9508
Practice Address - Country:US
Practice Address - Phone:937-578-8313
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-04
Last Update Date:2022-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH8001290Medicaid