Healthcare Provider Details

I. General information

NPI: 1073449617
Provider Name (Legal Business Name): DONYA CASSIDY RN, BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11764 STATE ROUTE 139
MINFORD OH
45653-8544
US

IV. Provider business mailing address

11764 STATE ROUTE 139
MINFORD OH
45653-8544
US

V. Phone/Fax

Practice location:
  • Phone: 740-771-1744
  • Fax:
Mailing address:
  • Phone: 740-771-1744
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.444972
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: