Provider Demographics
NPI:1548434202
Name:THOMPSON, DONISHA RAYNIECE (LPN)
Entity type:Individual
Prefix:
First Name:DONISHA
Middle Name:RAYNIECE
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7578 WILDBRANCH RD
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45011-7784
Mailing Address - Country:US
Mailing Address - Phone:513-642-5616
Mailing Address - Fax:
Practice Address - Street 1:7578 WILDBRANCH RD
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45011-7784
Practice Address - Country:US
Practice Address - Phone:513-642-5616
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-14
Last Update Date:2008-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN127084164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse