Provider Demographics
NPI:1396430518
Name:PRICE, DONNA L (HOME HEALTH AIDE)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:L
Last Name:PRICE
Suffix:
Gender:F
Credentials:HOME HEALTH AIDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:437 GREENLEAF SQ
Mailing Address - Street 2:
Mailing Address - City:PORT ORANGE
Mailing Address - State:FL
Mailing Address - Zip Code:32127-6709
Mailing Address - Country:US
Mailing Address - Phone:305-407-6296
Mailing Address - Fax:
Practice Address - Street 1:437 GREENLEAF SQ
Practice Address - Street 2:
Practice Address - City:PORT ORANGE
Practice Address - State:FL
Practice Address - Zip Code:32127-6709
Practice Address - Country:US
Practice Address - Phone:305-407-6296
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-05
Last Update Date:2023-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2864374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide