MEDICARE: AMANDA KATE DONOHOE ATC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2255A2300X	Athletic Trainer	1113	TN
2	2255A2300X	Athletic Trainer		IL

General Provider Information

NPI Number	:	1235102666
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA KATE DONOHOE ATC

Provider Business Mailing Address
First Line	:	4109 TEA GARDEN WAY
Second Line	:
City	:	ANTIOCH
State	:	TN
Zip	:	37013-5440
Country	:	US
Telephone Number	:	773-420-7751
Fax Number	:

Provider Business Practice Location Address
First Line	:	1220 MEDICAL CTR E
Second Line	:	SOUTH TOWER, SUITE 3200
City	:	NASHVILLE
State	:	TN
Zip	:	37232-0001
Country	:	US
Telephone Number	:	615-418-1033
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/08/2006
Last Update Date	:	07/08/2007

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