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General NPI Number Information
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NPI Number | 1457548760
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Entity Type | Individual
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Provider Name | KIMBERLY R DONOHUE MD
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Gender | Female
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Dates
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Enumeration Date | 10/01/2007
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Last Update Date | 11/05/2024
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Provider Practice Location Address
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Address Line | 14 GREAT PLAINS RD
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City | ARAPAHOE
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State | WY
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Zip | 82510
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Country | US
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Telephone | 307-856-9281
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Fax |
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Provider Business Mailing Address
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Address Line | 2300 ROSE LN
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City | RIVERTON
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State | WY
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Zip | 82501-2257
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Country | US
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Telephone | 307-857-1211
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Fax | 307-847-1439
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 8479A
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License Number State | WY
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ML20008891
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License Number State | WA
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