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General NPI Number Information
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NPI Number | 1275410722
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Entity Type | Individual
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Provider Name | DONNA L. EVERETT PTA
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Gender | Female
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Dates
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Enumeration Date | 08/18/2025
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Last Update Date | 08/18/2025
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Provider Practice Location Address
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Address Line | 1205 MANN DR
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City | MATTHEWS
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State | NC
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Zip | 28105-7592
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Country | US
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Telephone | 980-306-2539
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Fax |
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Provider Business Mailing Address
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Address Line | 1205 MANN DR
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City | MATTHEWS
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State | NC
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Zip | 28105-7592
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Country | US
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Telephone | 980-306-2539
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Fax | 980-306-2539
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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 | 204C00000X
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Taxonomy Name | Sports Medicine (Neuromusculoskeletal Medicine) Physician
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License Number | A938
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License Number State | NC
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