Provider Demographics
NPI:1578377594
Name:CLAYBORNE, DONISHA SHONTIA
Entity type:Individual
Prefix:
First Name:DONISHA
Middle Name:SHONTIA
Last Name:CLAYBORNE
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 1:215 BROADUS ST
Mailing Address - Street 2:
Mailing Address - City:STURGIS
Mailing Address - State:MI
Mailing Address - Zip Code:49091-1384
Mailing Address - Country:US
Mailing Address - Phone:269-651-4500
Mailing Address - Fax:
Practice Address - Street 1:1035 4TH ST NW APT 301
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20001-3586
Practice Address - Country:US
Practice Address - Phone:202-436-2910
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-03
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide