Provider Demographics
NPI:1528330446
Name:VOGEL, DONNA J (APRNCNP)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:J
Last Name:VOGEL
Suffix:
Gender:F
Credentials:APRNCNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 CORPORATE CENTER DR
Mailing Address - Street 2:
Mailing Address - City:VANDALIA
Mailing Address - State:OH
Mailing Address - Zip Code:45377-1169
Mailing Address - Country:US
Mailing Address - Phone:937-619-0050
Mailing Address - Fax:937-619-0069
Practice Address - Street 1:505 CORPORATE CENTER DR
Practice Address - Street 2:
Practice Address - City:VANDALIA
Practice Address - State:OH
Practice Address - Zip Code:45377-1169
Practice Address - Country:US
Practice Address - Phone:937-619-0050
Practice Address - Fax:937-619-0069
Is Sole Proprietor?:No
Enumeration Date:2012-02-08
Last Update Date:2019-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.12981363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHP0103126OtherRR MEDICARE
OH421534506188OtherCARESOURCE
OH00000075212OtherANTHEM BCBS OHIO
OH752128OtherBCBS OHIO
OH421534506188OtherCARESOURCE