Provider Demographics
NPI:1275769689
Name:ROYAL, DONNA DAUGHTRY (RN)
Entity Type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:DAUGHTRY
Last Name:ROYAL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:360 COUNTY COMPLEX RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CLINTON
Mailing Address - State:NC
Mailing Address - Zip Code:28328-4778
Mailing Address - Country:US
Mailing Address - Phone:910-592-1131
Mailing Address - Fax:910-592-1901
Practice Address - Street 1:360 COUNTY COMPLEX RD
Practice Address - Street 2:SUITE 200
Practice Address - City:CLINTON
Practice Address - State:NC
Practice Address - Zip Code:28328-4778
Practice Address - Country:US
Practice Address - Phone:910-592-1131
Practice Address - Fax:910-592-1901
Is Sole Proprietor?:No
Enumeration Date:2009-06-01
Last Update Date:2009-06-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC201425163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3404382Medicaid
NC3404382Medicaid