Provider Demographics
NPI:1164445664
Name:CORDES, DONNA MAE (CRNP)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:MAE
Last Name:CORDES
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1411 PIEDMONT CUTOFF
Mailing Address - Street 2:
Mailing Address - City:GADSDEN
Mailing Address - State:AL
Mailing Address - Zip Code:35903-2708
Mailing Address - Country:US
Mailing Address - Phone:256-492-0131
Mailing Address - Fax:256-494-6000
Practice Address - Street 1:801 NOBLE ST # 400
Practice Address - Street 2:
Practice Address - City:ANNISTON
Practice Address - State:AL
Practice Address - Zip Code:36201-5698
Practice Address - Country:US
Practice Address - Phone:256-770-4083
Practice Address - Fax:256-405-4997
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2020-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1044510363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL128480Medicaid
AL102I506922Medicare PIN