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General NPI Number Information
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NPI Number | 1417110396
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Entity Type | Individual
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Provider Name | JACQUELINE M DONAHUE OD
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Gender | Female
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Dates
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Enumeration Date | 07/09/2008
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Last Update Date | 09/13/2023
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Provider Practice Location Address
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Address Line | 500 W PLUMB LN STE A
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City | RENO
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State | NV
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Zip | 89509-3688
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Country | US
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Telephone | 775-284-3937
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Fax |
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Provider Business Mailing Address
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Address Line | 3333 QUALITY DR
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City | RANCHO CORDOVA
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State | CA
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Zip | 95670-7985
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Country | US
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Telephone | 614-784-5331
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 622
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License Number State | NV
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