Healthcare Provider Details

I. General information

NPI: 1467687087
Provider Name (Legal Business Name): ANDREA DONMYER CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2009
Last Update Date: 06/06/2023
Certification Date: 06/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 OSBORN BLVD
SAULT SAINTE MARIE MI
49783-1822
US

IV. Provider business mailing address

500 OSBORN BLVD
SAULT SAINTE MARIE MI
49783-1822
US

V. Phone/Fax

Practice location:
  • Phone: 906-635-3002
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number4704231068
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License Number4704231068
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: