Provider Demographics
NPI:1083034458
Name:HERMIDA, DONNA (RN)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:HERMIDA
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 1:7395 HODGSON MEMORIAL DR
Mailing Address - Street 2:STE 101
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406-1505
Mailing Address - Country:US
Mailing Address - Phone:912-208-0883
Mailing Address - Fax:888-391-0298
Practice Address - Street 1:123 GLYNDALE DR
Practice Address - Street 2:STE 101
Practice Address - City:BRUNSWICK
Practice Address - State:GA
Practice Address - Zip Code:31520-1403
Practice Address - Country:US
Practice Address - Phone:912-388-2320
Practice Address - Fax:888-391-0298
Is Sole Proprietor?:No
Enumeration Date:2014-04-23
Last Update Date:2014-04-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GARN141097163W00000X, 163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse