Provider Demographics
NPI:1891381943
Name:BERGER, DONNA SUSAN
Entity Type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:SUSAN
Last Name:BERGER
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 1:576 SAGE RUN DR
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:OH
Mailing Address - Zip Code:45036-3918
Mailing Address - Country:US
Mailing Address - Phone:513-228-0672
Mailing Address - Fax:
Practice Address - Street 1:576 SAGE RUN DR
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:OH
Practice Address - Zip Code:45036-3918
Practice Address - Country:US
Practice Address - Phone:502-777-9854
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-14
Last Update Date:2020-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant