Provider Demographics
NPI:1326227463
Name:DONOVAN, LOIS M (NP)
Entity Type:Individual
Prefix:MS
First Name:LOIS
Middle Name:M
Last Name:DONOVAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:132 WOODLAND AVE
Mailing Address - Street 2:
Mailing Address - City:NEPTUNE CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07753-6317
Mailing Address - Country:US
Mailing Address - Phone:732-361-7963
Mailing Address - Fax:
Practice Address - Street 1:80 PAVILION AVE
Practice Address - Street 2:
Practice Address - City:LONG BRANCH
Practice Address - State:NJ
Practice Address - Zip Code:07740-6413
Practice Address - Country:US
Practice Address - Phone:732-571-1535
Practice Address - Fax:732-571-5115
Is Sole Proprietor?:No
Enumeration Date:2007-10-25
Last Update Date:2007-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NN05296100363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health