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General NPI Number Information
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NPI Number | 1932875002
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Entity Type | Individual
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Provider Name | KRISTIN DONNELLY APNP
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Gender | Female
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Dates
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Enumeration Date | 08/19/2021
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Last Update Date | 01/21/2026
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Provider Practice Location Address
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Address Line | 2165 NW SHEVLIN PARK RD
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City | BEND
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State | OR
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Zip | 97703-7101
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Country | US
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Telephone | 541-317-5600
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Fax | 541-317-5676
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Provider Business Mailing Address
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Address Line | PO BOX 1517
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City | PENDLETON
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State | OR
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Zip | 97801-0410
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Country | US
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Telephone | 877-708-1119
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Fax | 541-278-8349
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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 | 11230-33
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License Number State | WI
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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 | 10051697
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License Number State | OR
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