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General NPI Number Information
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NPI Number | 1154031169
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Entity Type | Individual
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Provider Name | KIMBERLY ANN DONALDSON MSN, PMHNP-BC, APNP
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Gender | Female
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Dates
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Enumeration Date | 11/30/2022
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Last Update Date | 01/08/2024
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Provider Practice Location Address
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Address Line | 2600 65TH AVE
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City | OSCEOLA
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State | WI
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Zip | 54020-4376
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Country | US
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Telephone | 715-294-2111
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Fax |
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Provider Business Mailing Address
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Address Line | 2600 65TH AVE
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City | OSCEOLA
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State | WI
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Zip | 54020-4376
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Country | US
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Telephone | 715-294-2111
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | 171416-30
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | R194368-7
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License Number State | MN
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 14594-33
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License Number State | WI
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