1518095272 NPI number — MRS. DONNA JEAN FINNEGAN APRN,BC

Table of content: MRS. DONNA JEAN FINNEGAN APRN,BC (NPI 1518095272)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518095272 NPI number — MRS. DONNA JEAN FINNEGAN APRN,BC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FINNEGAN
Provider First Name:
DONNA
Provider Middle Name:
JEAN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
APRN,BC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1518095272
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1356
Provider Second Line Business Mailing Address:
755 N OLD COACH RD
Provider Business Mailing Address City Name:
DEWEY
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
86327-1356
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
928-632-1420
Provider Business Mailing Address Fax Number:
602-476-2453

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
HC76 HWY 89A N JCT 151
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PRESCOTT VALLEY
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
86314
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
602-435-2000
Provider Business Practice Location Address Fax Number:
602-476-2453
Provider Enumeration Date:
03/02/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363L00000X , with the licence number:  AP2604 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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