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General NPI Number Information
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NPI Number | 1831485895
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Entity Type | Individual
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Provider Name | ANITA SHARYL CLINTON DONEGAN WHNP
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Gender | Female
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Dates
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Enumeration Date | 06/28/2011
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Last Update Date | 06/28/2011
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Provider Practice Location Address
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Address Line | 1012 BIG LANE DR
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City | BROOKHAVEN
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State | MS
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Zip | 39601-2331
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Country | US
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Telephone | 601-835-3949
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Fax | 601-833-1633
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Provider Business Mailing Address
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Address Line | 1012 BIG LANE DR
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City | BROOKHAVEN
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State | MS
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Zip | 39601-2331
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Country | US
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Telephone | 601-835-3949
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Fax | 601-833-1633
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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 | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | R854109
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License Number State | MS
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