Provider Demographics
NPI:1669279204
Name:DONKOR, BEN
Entity type:Individual
Prefix:
First Name:BEN
Middle Name:
Last Name:DONKOR
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2243 WISDOMS CT
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:IN
Mailing Address - Zip Code:46123-7282
Mailing Address - Country:US
Mailing Address - Phone:317-835-1391
Mailing Address - Fax:
Practice Address - Street 1:2243 WISDOMS CT
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:IN
Practice Address - Zip Code:46123-7282
Practice Address - Country:US
Practice Address - Phone:317-835-1391
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-01
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN27068288A164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse