Provider Demographics
NPI:1235102666
Name:DONOHOE, AMANDA KATE (ATC)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:KATE
Last Name:DONOHOE
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4109 TEA GARDEN WAY
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:TN
Mailing Address - Zip Code:37013-5440
Mailing Address - Country:US
Mailing Address - Phone:773-420-7751
Mailing Address - Fax:
Practice Address - Street 1:1220 MEDICAL CTR E
Practice Address - Street 2:SOUTH TOWER, SUITE 3200
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37232-0001
Practice Address - Country:US
Practice Address - Phone:615-418-1033
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN11132255A2300X
IL2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer