Provider Demographics
NPI:1407296338
Name:DONEHUE, ANDREA MARGARET (NP)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:MARGARET
Last Name:DONEHUE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:15474 HAGGERTY RD
Mailing Address - Street 2:
Mailing Address - City:NORTHVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48170
Mailing Address - Country:US
Mailing Address - Phone:734-335-6103
Mailing Address - Fax:630-528-9507
Practice Address - Street 1:1886 W AUBURN RD
Practice Address - Street 2:SUITE 400
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48309-3865
Practice Address - Country:US
Practice Address - Phone:248-290-3111
Practice Address - Fax:248-290-3100
Is Sole Proprietor?:No
Enumeration Date:2013-06-25
Last Update Date:2015-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704221307363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner