Donald Cornelius Straut Jr., LPN
Individual provider Active NPI Licensed Practical Nurse · Helenwood, TN
NPI 1104396050 · NPPES record last updated Dec 3, 2018
Key facts
- NPI
- 1104396050
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Practical Nurse 164W00000X
- License
- 0000090219 (TN)
- Practice address
- 378 Old Brimstone Rd
Helenwood, TN 37755-5432 - Phone
- (423) 223-4412
- Fax
- (423) 663-8980
- NPI assigned
- Dec 3, 2018
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0000090219 | TN | MD | Licensed Practical Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 0000090219 | TN | Yes |
Addresses
Primary practice location
378 Old Brimstone Rd
Helenwood, TN 37755-5432
Mailing address
378 Old Brimstone Rd
Helenwood, TN 37755-5432
Phone (423) 223-4412
Other providers in Helenwood, TN
- Rhonda Jean Jeffers
- Littles Drugs and Fountain, Inc.
- Selena Myers
- Mary Sexton
- Kristie Lynn Sims-Straut
- Alayna Grace Williams
All providers in Helenwood, TN · Licensed Practical Nurse in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 3, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.