Provider Demographics
NPI:1952354391
Name:KUTA, DONNA M (CNP)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:M
Last Name:KUTA
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36000 EUCLID AVE
Mailing Address - Street 2:ANTICOAGULATION CLINIC
Mailing Address - City:WILLOUGHBY
Mailing Address - State:OH
Mailing Address - Zip Code:44094-4625
Mailing Address - Country:US
Mailing Address - Phone:440-639-0393
Mailing Address - Fax:440-953-6037
Practice Address - Street 1:36000 EUCLID AVE
Practice Address - Street 2:SUITE 309
Practice Address - City:WILLOUGHBY
Practice Address - State:OH
Practice Address - Zip Code:44094-4625
Practice Address - Country:US
Practice Address - Phone:440-953-6030
Practice Address - Fax:440-639-0393
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2016-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN278342163W00000X
OHCOA.07228363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000512374OtherANTHEM
OH2630648Medicaid
OH000000512374OtherANTHEM
OH2630648Medicaid