Healthcare Provider Details

I. General information

NPI: 1427327436
Provider Name (Legal Business Name): DEANNA DONOHUE CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/20/2011
Last Update Date: 08/16/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 CENTRAL AVE
EGG HARBOR TOWNSHIP NJ
08234-8340
US

IV. Provider business mailing address

PO BOX 95000-3400
PHILADELPHIA PA
19195-0001
US

V. Phone/Fax

Practice location:
  • Phone: 908-653-9399
  • Fax:
Mailing address:
  • Phone: 908-653-9399
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number26NR12029800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: