Provider Demographics
NPI:1073883013
Name:BIERUT, DONNA KAY (MSN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:KAY
Last Name:BIERUT
Suffix:
Gender:F
Credentials:MSN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1985 FIRST ST STE 205
Mailing Address - Street 2:
Mailing Address - City:LIVERMORE
Mailing Address - State:CA
Mailing Address - Zip Code:94550-4485
Mailing Address - Country:US
Mailing Address - Phone:925-484-5483
Mailing Address - Fax:925-484-5427
Practice Address - Street 1:1985 FIRST ST STE 205
Practice Address - Street 2:
Practice Address - City:LIVERMORE
Practice Address - State:CA
Practice Address - Zip Code:94550-4485
Practice Address - Country:US
Practice Address - Phone:925-484-5483
Practice Address - Fax:925-484-5427
Is Sole Proprietor?:No
Enumeration Date:2012-01-06
Last Update Date:2015-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP 21432363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care