Healthcare Provider Details

I. General information

NPI: 1063419802
Provider Name (Legal Business Name): DONNA M. LEMIEUX C.R.N.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2005
Last Update Date: 08/02/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2690 SOUTHFIELD DRIVE
YORK PA
17403-4510
US

IV. Provider business mailing address

19417 E CRESTRIDGE CIR
CENTENNIAL CO
80015-3735
US

V. Phone/Fax

Practice location:
  • Phone: 717-741-1414
  • Fax: 717-741-4774
Mailing address:
  • Phone: 720-490-1770
  • Fax: 303-205-5534

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN600035
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: