Provider Demographics
NPI:1528475738
Name:DONKOR, ITHEA
Entity type:Individual
Prefix:
First Name:ITHEA
Middle Name:
Last Name:DONKOR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 HEFFRON DR
Mailing Address - Street 2:APT 12
Mailing Address - City:FAIRFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45014-7712
Mailing Address - Country:US
Mailing Address - Phone:513-344-6376
Mailing Address - Fax:
Practice Address - Street 1:20 HEFFRON DR
Practice Address - Street 2:APT 12
Practice Address - City:FAIRFIELD
Practice Address - State:OH
Practice Address - Zip Code:45014-7712
Practice Address - Country:US
Practice Address - Phone:513-344-6376
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-20
Last Update Date:2014-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide