Provider Demographics
NPI:1417072653
Name:DONOHUE, MEGAN FRAYNE (RN NP)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:FRAYNE
Last Name:DONOHUE
Suffix:
Gender:F
Credentials:RN NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7809 WISCONSIN AVE
Mailing Address - Street 2:MINUTECLINIC LLC
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-3523
Mailing Address - Country:US
Mailing Address - Phone:866-389-2727
Mailing Address - Fax:
Practice Address - Street 1:7809 WISCONSIN AVE
Practice Address - Street 2:MINUTECLINIC LLC
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-3523
Practice Address - Country:US
Practice Address - Phone:866-389-2727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2013-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN64914363L00000X
MDR133496363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC22524700Medicaid
14725C58Medicare ID - Type Unspecified
DC22524700Medicaid