Provider Demographics
NPI:1245606193
Name:DONAHUE, ALYSSA M (ARNP)
Entity Type:Individual
Prefix:
First Name:ALYSSA
Middle Name:M
Last Name:DONAHUE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 HAWKINS DR
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52242-1009
Mailing Address - Country:US
Mailing Address - Phone:563-344-2240
Mailing Address - Fax:563-344-2244
Practice Address - Street 1:865 LINCOLN RD
Practice Address - Street 2:
Practice Address - City:BETTENDORF
Practice Address - State:IA
Practice Address - Zip Code:52722-4190
Practice Address - Country:US
Practice Address - Phone:563-344-2240
Practice Address - Fax:563-344-2244
Is Sole Proprietor?:No
Enumeration Date:2015-08-14
Last Update Date:2021-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA-125439363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAA-107772OtherIOWA LICENSE