Provider Demographics
NPI:1033116587
Name:MCGHEE, DONNA (NP)
Entity Type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:
Last Name:MCGHEE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 PARK PL
Mailing Address - Street 2:
Mailing Address - City:SWANSEA
Mailing Address - State:IL
Mailing Address - Zip Code:62226-2923
Mailing Address - Country:US
Mailing Address - Phone:618-233-5722
Mailing Address - Fax:618-233-7069
Practice Address - Street 1:12 PARK PL
Practice Address - Street 2:
Practice Address - City:SWANSEA
Practice Address - State:IL
Practice Address - Zip Code:62226-2923
Practice Address - Country:US
Practice Address - Phone:618-233-5722
Practice Address - Fax:618-233-7069
Is Sole Proprietor?:No
Enumeration Date:2005-06-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO2002017083OtherLICENSE