Provider Demographics
NPI:1669090098
Name:MCDONALD, CONSTANCE JO
Entity type:Individual
Prefix:
First Name:CONSTANCE
Middle Name:JO
Last Name:MCDONALD
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 1:1025 FRANCIS AVE
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43609-1915
Mailing Address - Country:US
Mailing Address - Phone:386-956-9568
Mailing Address - Fax:
Practice Address - Street 1:1025 FRANCIS AVE
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43609-1915
Practice Address - Country:US
Practice Address - Phone:386-956-9568
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-13
Last Update Date:2020-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker