Provider Demographics
NPI:1437356763
Name:CONWAY, DONNA L (RN, MS, CPNP)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:L
Last Name:CONWAY
Suffix:
Gender:F
Credentials:RN, MS, CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9113 DICKEY DR
Mailing Address - Street 2:
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23116-2502
Mailing Address - Country:US
Mailing Address - Phone:804-559-7280
Mailing Address - Fax:804-559-7282
Practice Address - Street 1:9113 DICKEY DR
Practice Address - Street 2:
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23116-2502
Practice Address - Country:US
Practice Address - Phone:804-559-7280
Practice Address - Fax:804-559-7282
Is Sole Proprietor?:No
Enumeration Date:2007-06-29
Last Update Date:2011-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024074372363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC05700OtherGROUP PTAN
VAC06115OtherGROUP PTAN