Healthcare Provider Details

I. General information

NPI: 1538560438
Provider Name (Legal Business Name): CORA DONAHUE APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/10/2014
Last Update Date: 09/28/2023
Certification Date: 09/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 MEMBERS WAY STE 300
DOVER NH
03820-5933
US

IV. Provider business mailing address

PO BOX 412503
BOSTON MA
02241-2503
US

V. Phone/Fax

Practice location:
  • Phone: 603-749-0913
  • Fax:
Mailing address:
  • Phone: 617-726-3884
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number043605-23
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: