Provider Demographics
NPI:1114265105
Name:KANE, DONNA LEAH (RN)
Entity Type:Individual
Prefix:MS
First Name:DONNA
Middle Name:LEAH
Last Name:KANE
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 1:15870 COUNTY ROUTE 5
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:NY
Mailing Address - Zip Code:13624-3116
Mailing Address - Country:US
Mailing Address - Phone:315-686-2539
Mailing Address - Fax:
Practice Address - Street 1:410 ESSELSTYNE ST
Practice Address - Street 2:
Practice Address - City:CAPE VINCENT
Practice Address - State:NY
Practice Address - Zip Code:13618
Practice Address - Country:US
Practice Address - Phone:315-654-2142
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-25
Last Update Date:2013-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY426908-1163WM0705X, 163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical