Provider Demographics
NPI:1134206113
Name:WORKMAN, DONNA LEE JUDKINS (CNP)
Entity type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:LEE JUDKINS
Last Name:WORKMAN
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:DONNA
Other - Middle Name:J
Other - Last Name:WORKMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CNP
Mailing Address - Street 1:530 LIBERTY ST
Mailing Address - Street 2:
Mailing Address - City:CONNEAUT
Mailing Address - State:OH
Mailing Address - Zip Code:44030-2625
Mailing Address - Country:US
Mailing Address - Phone:440-228-0506
Mailing Address - Fax:440-593-5799
Practice Address - Street 1:530 LIBERTY ST
Practice Address - Street 2:
Practice Address - City:CONNEAUT
Practice Address - State:OH
Practice Address - Zip Code:44030-2625
Practice Address - Country:US
Practice Address - Phone:440-228-0506
Practice Address - Fax:440-593-5799
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2024-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH245284163WP0808X
OHRN245284;CTPNP08104363LP0808X
OH08104363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0110480Medicaid
OHNONEMedicaid
OH2873967Medicaid