MEDICARE: MRS. DONNA KAY LO CNM

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	367A00000X	Advanced Practice Midwife	12825	NC
2	367A00000X	Advanced Practice Midwife	429	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1487892287
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DONNA KAY LO CNM

Provider Business Mailing Address
First Line	:	PO BOX 344
Second Line	:
City	:	WINSTON SALEM
State	:	NC
Zip	:	27102-0344
Country	:	US
Telephone Number	:	336-760-2821
Fax Number	:

Provider Business Practice Location Address
First Line	:	3518 DRAWBRIDGE PKWY STE 310
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27410-8432
Country	:	US
Telephone Number	:	336-890-3180
Fax Number	:	336-890-2937

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

Provider Enumeration Date	:	02/02/2009
Last Update Date	:	10/03/2024

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