Provider Demographics
NPI:1487495941
Name:OATTS, DONIESHA RONYAE
Entity type:Individual
Prefix:
First Name:DONIESHA
Middle Name:RONYAE
Last Name:OATTS
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 1:6433 E WASHINGTON ST STE 155
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46219-6678
Mailing Address - Country:US
Mailing Address - Phone:317-397-4891
Mailing Address - Fax:423-927-2558
Practice Address - Street 1:6433 E WASHINGTON ST STE 155
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46219-6678
Practice Address - Country:US
Practice Address - Phone:317-397-4891
Practice Address - Fax:423-927-2558
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-06
Last Update Date:2024-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care