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General NPI Number Information
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NPI Number | 1497307268
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Entity Type | Individual
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Provider Name | MARY DONIKOWSKI CRNP
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Gender | Female
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Dates
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Enumeration Date | 07/11/2019
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Last Update Date | 07/11/2019
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Provider Practice Location Address
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Address Line | 7200 PEACH ST UNIT 420
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City | ERIE
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State | PA
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Zip | 16509-4759
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Country | US
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Telephone | 814-864-0437
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Fax |
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Provider Business Mailing Address
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Address Line | 230 ARBUCKLE RD
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City | ERIE
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State | PA
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Zip | 16509-3706
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Country | US
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Telephone | 814-790-4463
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | SP018483
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License Number State | PA
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