NPI Code Details Logo

NPI 1053483644

NPI 1053483644 : DONNA JO MCDONALD APN, CNM, MSN : GRAY, TN

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1053483644
-----------------------------------------------------
    Entity Type          |    Individual 
-----------------------------------------------------
    Provider Name        |    DONNA JO MCDONALD APN, CNM, MSN
-----------------------------------------------------
    Gender               |    Female 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    11/15/2006
-----------------------------------------------------
    Last Update Date     |    01/31/2025
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    115 JUDGE GRESHAM RD STE A 
-----------------------------------------------------
    City                 |    GRAY
-----------------------------------------------------
    State                |    TN
-----------------------------------------------------
    Zip                  |    37615-6213
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    423-467-3000
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    1021 W OAKLAND AVE STE 310 
-----------------------------------------------------
    City                 |    JOHNSON CITY
-----------------------------------------------------
    State                |    TN
-----------------------------------------------------
    Zip                  |    37604-2192
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    423-952-2111
-----------------------------------------------------
    Fax                  |    423-282-1657
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    
-----------------------------------------------------
    Name                 |        
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    176B00000X
-----------------------------------------------------
    Taxonomy Name        |    Midwife
-----------------------------------------------------
    License Number       |    CNM710
-----------------------------------------------------
    License Number State |    NC
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
    Taxonomy Code        |    367A00000X
-----------------------------------------------------
    Taxonomy Name        |    Advanced Practice Midwife
-----------------------------------------------------
    License Number       |    CNM710
-----------------------------------------------------
    License Number State |    NC
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
    Taxonomy Code        |    367A00000X
-----------------------------------------------------
    Taxonomy Name        |    Advanced Practice Midwife
-----------------------------------------------------
    License Number       |    APN0000006347
-----------------------------------------------------
    License Number State |    TN
-----------------------------------------------------



                        

Copyright © 2007-2025 Data Labs Health. All rights reserved.