Healthcare Provider Details
I. General information
NPI: 1821506189
Provider Name (Legal Business Name): ASHLEY REA DONAHUE FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 01/19/2018
Last Update Date: 06/28/2023
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2000 COUNTY SERVICES DR
PELHAM AL
35124-6149
US
IV. Provider business mailing address
201 MONROE ST STE 1350
MONTGOMERY AL
36104-3773
US
V. Phone/Fax
- Phone: 205-664-2470
- Fax: 205-664-4148
- Phone: 334-206-5675
- Fax: 334-206-3998
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | F06172326 |
| License Number State | AL |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LG0600X |
| Taxonomy | Gerontology Nurse Practitioner |
| License Number | 1-134459 |
| License Number State | AL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: