Provider Demographics
NPI:1063630549
Name:TOLOSA, DONNA ANN (RN)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:ANN
Last Name:TOLOSA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7262 SHORE DR
Mailing Address - Street 2:
Mailing Address - City:HARRISON
Mailing Address - State:TN
Mailing Address - Zip Code:37341-9633
Mailing Address - Country:US
Mailing Address - Phone:423-344-4722
Mailing Address - Fax:
Practice Address - Street 1:5625 HIGHWAY 60
Practice Address - Street 2:
Practice Address - City:BIRCHWOOD
Practice Address - State:TN
Practice Address - Zip Code:37308-5155
Practice Address - Country:US
Practice Address - Phone:423-961-0446
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN0000107691163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse