Provider Demographics
NPI:1023709367
Name:YOUNGBLOOD, DONNALYN DJUAN
Entity type:Individual
Prefix:
First Name:DONNALYN
Middle Name:DJUAN
Last Name:YOUNGBLOOD
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 1:822 ROSLYN AVE
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44320-1847
Mailing Address - Country:US
Mailing Address - Phone:330-601-7999
Mailing Address - Fax:
Practice Address - Street 1:822 ROSLYN AVE
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44320-1847
Practice Address - Country:US
Practice Address - Phone:330-601-7999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-17
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide