Provider Demographics
NPI:1417231986
Name:ROTHMAN, DONNA ANNETTE (CRNP)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:ANNETTE
Last Name:ROTHMAN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 JOHNSTON RD
Mailing Address - Street 2:
Mailing Address - City:UPPER SAINT CLAIR
Mailing Address - State:PA
Mailing Address - Zip Code:15241-2554
Mailing Address - Country:US
Mailing Address - Phone:412-833-2887
Mailing Address - Fax:
Practice Address - Street 1:141 JOHNSTON RD
Practice Address - Street 2:
Practice Address - City:UPPER SAINT CLAIR
Practice Address - State:PA
Practice Address - Zip Code:15241-2554
Practice Address - Country:US
Practice Address - Phone:412-833-2887
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-03
Last Update Date:2011-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAVP005201M363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care