Provider Demographics
NPI:1003282120
Name:PAUSE, DONNA JENKINS (NP-C)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:JENKINS
Last Name:PAUSE
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:517 GREAT OAKS DR
Mailing Address - Street 2:SUITE 102
Mailing Address - City:MONROE
Mailing Address - State:GA
Mailing Address - Zip Code:30655-8211
Mailing Address - Country:US
Mailing Address - Phone:770-267-6565
Mailing Address - Fax:770-267-1524
Practice Address - Street 1:517 GREAT OAKS DR
Practice Address - Street 2:SUITE 102
Practice Address - City:MONROE
Practice Address - State:GA
Practice Address - Zip Code:30655-8211
Practice Address - Country:US
Practice Address - Phone:770-267-6565
Practice Address - Fax:770-267-1524
Is Sole Proprietor?:No
Enumeration Date:2015-08-12
Last Update Date:2016-02-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GARN129689363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily