Healthcare Provider Details

I. General information

NPI: 1124592472
Provider Name (Legal Business Name): DEANNE DONAWAY PHD, AGPCNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/18/2019
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

312 E HOLLY BLVD
BRANDON SD
57005-1240
US

IV. Provider business mailing address

2501 S LOUISE AVE UNIT 90332
SIOUX FALLS SD
57109-4669
US

V. Phone/Fax

Practice location:
  • Phone: 605-250-1200
  • Fax:
Mailing address:
  • Phone: 605-250-1200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR030519
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: