Provider Demographics
NPI:1669860029
Name:MCCOY-DOWDELL, DONNA RUTH
Entity Type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:RUTH
Last Name:MCCOY-DOWDELL
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 1:924 MORNINGSTAR DR
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44307-2207
Mailing Address - Country:US
Mailing Address - Phone:330-634-6143
Mailing Address - Fax:
Practice Address - Street 1:924 MORNINGSTAR DR
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44307-2207
Practice Address - Country:US
Practice Address - Phone:330-634-6143
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-07
Last Update Date:2015-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN-139028-M-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse