Provider Demographics
NPI:1013393610
Name:LAKEY, DONNA (RN)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:LAKEY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:104 S MCKINLEY AVE
Mailing Address - Street 2:SUITE E
Mailing Address - City:UNION
Mailing Address - State:MO
Mailing Address - Zip Code:63084-1800
Mailing Address - Country:US
Mailing Address - Phone:636-583-5801
Mailing Address - Fax:636-583-7821
Practice Address - Street 1:104 S MCKINLEY AVE
Practice Address - Street 2:SUITE E
Practice Address - City:UNION
Practice Address - State:MO
Practice Address - Zip Code:63084-1800
Practice Address - Country:US
Practice Address - Phone:636-583-5801
Practice Address - Fax:636-583-7821
Is Sole Proprietor?:No
Enumeration Date:2015-08-05
Last Update Date:2015-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO134499163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse