Healthcare Provider Details

I. General information

NPI: 1720219348
Provider Name (Legal Business Name): DONNA M MACNEIL RN, DIPL ABT, ABT CP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2009
Last Update Date: 07/30/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

968 PLYMOUTH ST
EAST BRIDGEWATER MA
02333-2169
US

IV. Provider business mailing address

968 PLYMOUTH ST
EAST BRIDGEWATER MA
02333-2169
US

V. Phone/Fax

Practice location:
  • Phone: 774-273-3000
  • Fax: 508-378-8313
Mailing address:
  • Phone: 774-273-3000
  • Fax: 508-378-8313

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code146L00000X
TaxonomyParamedic
License Number821075
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number142206
License Number StateMA
# 3
Primary TaxonomyY
Taxonomy Code173C00000X
TaxonomyReflexologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: