Healthcare Provider Details

I. General information

NPI: 1053646687
Provider Name (Legal Business Name): DONNA SEWELL R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/15/2009
Last Update Date: 10/15/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2475 WESTERN
NORTH ROBINSON OH
44856-0122
US

IV. Provider business mailing address

PO BOX 122
NORTH ROBINSON OH
44856-0122
US

V. Phone/Fax

Practice location:
  • Phone: 419-561-1060
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberRN297003
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: