MEDICARE: ELIZABETH A DONIGAN CRNP

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	363LX0001X	Obstetrics & Gynecology Nurse Practitioner	ARNP 9216691	FL
2	363LX0001X	Obstetrics & Gynecology Nurse Practitioner	R66903	NM
3	363LX0001X	Obstetrics & Gynecology Nurse Practitioner	SP007054	PA
4	363LW0102X	Women's Health Nurse Practitioner	CNP01470	NM

General Provider Information

NPI Number	:	1861428344
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH A DONIGAN CRNP

Provider Business Mailing Address
First Line	:	1413 COLUMBUS RD
Second Line	:
City	:	DEMING
State	:	NM
Zip	:	88030-5251
Country	:	US
Telephone Number	:	575-546-6548
Fax Number	:	575-546-6540

Provider Business Practice Location Address
First Line	:	905 S 8TH ST STE B
Second Line	:
City	:	DEMING
State	:	NM
Zip	:	88030-4037
Country	:	US
Telephone Number	:	575-543-7200
Fax Number	:	575-546-6540

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

Provider Enumeration Date	:	06/24/2006
Last Update Date	:	06/09/2023

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