Provider Demographics
NPI:1528032216
Name:SETON, DONNA M (PA-C)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:M
Last Name:SETON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2238 N. DATON ST.
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85006
Mailing Address - Country:US
Mailing Address - Phone:602-264-4431
Mailing Address - Fax:602-241-5109
Practice Address - Street 1:2238 N DAYTON ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85006-1637
Practice Address - Country:US
Practice Address - Phone:602-264-4431
Practice Address - Fax:602-241-5109
Is Sole Proprietor?:No
Enumeration Date:2006-02-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2558363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZP52580Medicare UPIN
AZ100834Medicare ID - Type Unspecified