Provider Demographics
NPI:1447940531
Name:DONEGAN, BRENDA LOUISE (HM, PC, IA, CC)
Entity type:Individual
Prefix:
First Name:BRENDA
Middle Name:LOUISE
Last Name:DONEGAN
Suffix:
Gender:F
Credentials:HM, PC, IA, CC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:367 N COLUMBUS ST
Mailing Address - Street 2:
Mailing Address - City:XENIA
Mailing Address - State:OH
Mailing Address - Zip Code:45385-2150
Mailing Address - Country:US
Mailing Address - Phone:614-456-8008
Mailing Address - Fax:
Practice Address - Street 1:367 N. COLUMBUS STREET
Practice Address - Street 2:
Practice Address - City:XENIA
Practice Address - State:OH
Practice Address - Zip Code:45385
Practice Address - Country:US
Practice Address - Phone:614-456-8008
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-11
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker