Provider Demographics
NPI:1336460013
Name:DONNELLY, STEPHANIE ANN (DO)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:ANN
Last Name:DONNELLY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:1111 DUFF AVENUE
Mailing Address - Street 2:MCFARLAND CLINIC, PC
Mailing Address - City:AMES
Mailing Address - State:IA
Mailing Address - Zip Code:50010-3014
Mailing Address - Country:US
Mailing Address - Phone:515-239-2182
Mailing Address - Fax:515-239-3665
Practice Address - Street 1:1111 DUFF AVENUE
Practice Address - Street 2:MCFARLAND CLINIC, PC
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50010-3014
Practice Address - Country:US
Practice Address - Phone:515-239-2182
Practice Address - Fax:515-239-3665
Is Sole Proprietor?:No
Enumeration Date:2010-06-17
Last Update Date:2024-02-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IA04566207L00000X
MN54088207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN050002540Medicare PIN