Provider Demographics
NPI:1518011535
Name:DONALD, KATHERINE WEIDNER (RN)
Entity Type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:WEIDNER
Last Name:DONALD
Suffix:
Gender:F
Credentials:RN
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Mailing Address - Street 1:9889 E WINDY PASS TRL
Mailing Address - Street 2:
Mailing Address - City:GOLD CANYON
Mailing Address - State:AZ
Mailing Address - Zip Code:85218-4950
Mailing Address - Country:US
Mailing Address - Phone:480-982-6647
Mailing Address - Fax:480-288-4490
Practice Address - Street 1:10965 E PERALTA RD
Practice Address - Street 2:
Practice Address - City:GOLD CANYON
Practice Address - State:AZ
Practice Address - Zip Code:85218-4799
Practice Address - Country:US
Practice Address - Phone:480-982-1110
Practice Address - Fax:480-288-4490
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZRN108358163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ614231Medicaid