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General NPI Number Information
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NPI Number | 1306486030
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Entity Type | Individual
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Provider Name | ALLISON M DONOVAN
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Gender | Female
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Dates
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Enumeration Date | 01/10/2020
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Last Update Date | 03/10/2025
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Provider Practice Location Address
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Address Line | 565 CAMERON WAY STE 103
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City | NORTH LIBERTY
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State | IA
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Zip | 52317-4868
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Country | US
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Telephone | 319-499-5410
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Fax | 877-559-4490
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Provider Business Mailing Address
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Address Line | PO BOX 193
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City | NORTH LIBERTY
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State | IA
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Zip | 52317-0193
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Country | US
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Telephone | 319-499-5410
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | G175222
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | A157432
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License Number State | IA
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