MEDICARE: JEAN MARIE DONNAY APRN CNP

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	363LA2200X	Adult Health Nurse Practitioner	R0673592	MN
2	363LA2200X	Adult Health Nurse Practitioner	CNP2431	MN

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	:	1952380701
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEAN MARIE DONNAY APRN CNP

Provider Business Mailing Address
First Line	:	1360 ELM STREET EAST
Second Line	:	CENTRACARE CLINIC
City	:	ST JOSEPH
State	:	MN
Zip	:	56374-4694
Country	:	US
Telephone Number	:	320-363-7765
Fax Number	:	320-363-0031

Provider Business Practice Location Address
First Line	:	1360 ELM STREET EAST
Second Line	:	CENTRACARE CLINIC
City	:	ST JOSEPH
State	:	MN
Zip	:	56374-4694
Country	:	US
Telephone Number	:	320-363-7765
Fax Number	:	320-363-0031

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

Provider Enumeration Date	:	01/11/2006
Last Update Date	:	10/28/2015

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