Provider Demographics
NPI:1174411219
Name:CROCKETT, DONNA (APRN)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:CROCKETT
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
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Mailing Address - Street 1:132 MARIELLA DR
Mailing Address - Street 2:
Mailing Address - City:OWINGSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40360-2213
Mailing Address - Country:US
Mailing Address - Phone:859-585-5332
Mailing Address - Fax:
Practice Address - Street 1:160 N EAGLE CREEK DR STE 302
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-2124
Practice Address - Country:US
Practice Address - Phone:859-967-5044
Practice Address - Fax:859-967-5041
Is Sole Proprietor?:No
Enumeration Date:2025-06-26
Last Update Date:2025-06-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KY4042815207QS1201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS1201XAllopathic & Osteopathic PhysiciansFamily MedicineSleep Medicine