Provider Demographics
NPI:1407992811
Name:DONALDSON, MARTHA J (RN, BSN)
Entity Type:Individual
Prefix:MS
First Name:MARTHA
Middle Name:J
Last Name:DONALDSON
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:2521 STOCKTON BLVD
Mailing Address - Street 2:GLASSROCK #3300
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95817-2207
Mailing Address - Country:US
Mailing Address - Phone:916-734-5845
Mailing Address - Fax:916-734-5551
Practice Address - Street 1:2521 STOCKTON BLVD
Practice Address - Street 2:GLASSROCK #3300
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817-2207
Practice Address - Country:US
Practice Address - Phone:916-734-7006
Practice Address - Fax:916-734-5551
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN451870163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management