Provider Demographics
NPI:1356645154
Name:GATES, DONNA JEAN (NNP)
Entity Type:Individual
Prefix:MS
First Name:DONNA
Middle Name:JEAN
Last Name:GATES
Suffix:
Gender:F
Credentials:NNP
Other - Prefix:
Other - First Name:DONNA
Other - Middle Name:JEAN
Other - Last Name:UNSELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NNP
Mailing Address - Street 1:1102 W 32ND ST
Mailing Address - Street 2:
Mailing Address - City:JOPLIN
Mailing Address - State:MO
Mailing Address - Zip Code:64804-3503
Mailing Address - Country:US
Mailing Address - Phone:417-347-3413
Mailing Address - Fax:
Practice Address - Street 1:1102 W 32ND ST
Practice Address - Street 2:
Practice Address - City:JOPLIN
Practice Address - State:MO
Practice Address - Zip Code:64804-3503
Practice Address - Country:US
Practice Address - Phone:417-347-3413
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-07
Last Update Date:2011-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO152516363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal