Provider Demographics
NPI:1326637281
Name:TRAWICK, DONNA
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:TRAWICK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9268 TRAVELERS WAY
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:GA
Mailing Address - Zip Code:31820-5412
Mailing Address - Country:US
Mailing Address - Phone:706-505-3104
Mailing Address - Fax:
Practice Address - Street 1:9268 TRAVELERS WAY
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:GA
Practice Address - Zip Code:31820-5412
Practice Address - Country:US
Practice Address - Phone:706-505-3104
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-14
Last Update Date:2021-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA134925163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse