Provider Demographics
NPI:1366169856
Name:CUPOLI, DONNA JO
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:JO
Last Name:CUPOLI
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 1:509 WHEELER DR
Mailing Address - Street 2:
Mailing Address - City:DUNCAN FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:43734-9728
Mailing Address - Country:US
Mailing Address - Phone:740-819-5185
Mailing Address - Fax:
Practice Address - Street 1:509 WHEELER DR
Practice Address - Street 2:
Practice Address - City:DUNCAN FALLS
Practice Address - State:OH
Practice Address - Zip Code:43734-9728
Practice Address - Country:US
Practice Address - Phone:740-819-5185
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-25
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide