MEDICARE: CHRISTOPHER W DONNELLY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2100X	Acute Care Nurse Practitioner	230218	AZ

General Provider Information

NPI Number	:	1982434627
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER W DONNELLY

Provider Business Mailing Address
First Line	:	12009 N WASHBED DR
Second Line	:
City	:	ORO VALLEY
State	:	AZ
Zip	:	85755-8760
Country	:	US
Telephone Number	:	720-560-1709
Fax Number	:

Provider Business Practice Location Address
First Line	:	10515 N ORACLE RD STE 169
Second Line	:
City	:	ORO VALLEY
State	:	AZ
Zip	:	85737-9391
Country	:	US
Telephone Number	:	520-685-7330
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/06/2024
Last Update Date	:	05/12/2026

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