Healthcare Provider Details

I. General information

NPI: 1457174260
Provider Name (Legal Business Name): DONNA SUE HULL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/01/2024
Last Update Date: 11/01/2024
Certification Date: 11/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

580 E 2ND ST
CHILLICOTHEE OH
45601-2745
US

IV. Provider business mailing address

580 E 2ND ST
CHILLICOTHEE OH
45601-2745
US

V. Phone/Fax

Practice location:
  • Phone: 740-703-5141
  • Fax:
Mailing address:
  • Phone: 740-703-5141
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: