Healthcare Provider Details

I. General information

NPI: 1952380701
Provider Name (Legal Business Name): JEAN MARIE DONNAY APRN CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JEAN DONNAY N.P.

II. Dates (important events)

Enumeration Date: 01/11/2006
Last Update Date: 10/28/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1360 ELM STREET EAST CENTRACARE CLINIC
ST JOSEPH MN
56374-4694
US

IV. Provider business mailing address

1360 ELM STREET EAST CENTRACARE CLINIC
ST JOSEPH MN
56374-4694
US

V. Phone/Fax

Practice location:
  • Phone: 320-363-7765
  • Fax: 320-363-0031
Mailing address:
  • Phone: 320-363-7765
  • Fax: 320-363-0031

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberR0673592
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberCNP2431
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: