Provider Demographics
NPI:1497999791
Name:DOOLEY, DONNA JEAN (RN/BSN/RT)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:JEAN
Last Name:DOOLEY
Suffix:
Gender:F
Credentials:RN/BSN/RT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5404 CALICO CT
Mailing Address - Street 2:
Mailing Address - City:MC FARLAND
Mailing Address - State:WI
Mailing Address - Zip Code:53558-9573
Mailing Address - Country:US
Mailing Address - Phone:608-838-3635
Mailing Address - Fax:
Practice Address - Street 1:5404 CALICO CT
Practice Address - Street 2:
Practice Address - City:MC FARLAND
Practice Address - State:WI
Practice Address - Zip Code:53558-9573
Practice Address - Country:US
Practice Address - Phone:608-838-3635
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-30
Last Update Date:2009-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI167368-30163WH0200X
WI110128227800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
No227800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Certified