Provider Demographics
NPI:1245764521
Name:WALDIE, DONNA GAYE (APRN-C)
Entity Type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:GAYE
Last Name:WALDIE
Suffix:
Gender:F
Credentials:APRN-C
Other - Prefix:
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Mailing Address - Street 1:345 WINDSONG DR
Mailing Address - Street 2:
Mailing Address - City:HAWESVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42348-6703
Mailing Address - Country:US
Mailing Address - Phone:270-929-8500
Mailing Address - Fax:270-688-5112
Practice Address - Street 1:345 WINDSONG DR
Practice Address - Street 2:
Practice Address - City:HAWESVILLE
Practice Address - State:KY
Practice Address - Zip Code:42348-6703
Practice Address - Country:US
Practice Address - Phone:270-929-8500
Practice Address - Fax:270-688-5112
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-13
Last Update Date:2017-04-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY3002441363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology