Provider Demographics
NPI:1376562892
Name:WILLOME, DONNA M (NP)
Entity Type:Individual
Prefix:MS
First Name:DONNA
Middle Name:M
Last Name:WILLOME
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
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Mailing Address - Street 1:100 CITY VIEW DR
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14625-1308
Mailing Address - Country:US
Mailing Address - Phone:585-248-8973
Mailing Address - Fax:585-389-2503
Practice Address - Street 1:4245 EAST AVE.
Practice Address - Street 2:NAZARETH COLLEGE HEALTH SERVICES
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618
Practice Address - Country:US
Practice Address - Phone:585-389-2501
Practice Address - Fax:585-389-2503
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYF300664363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health