Provider Demographics
NPI:1558375782
Name:WHITMAN, DONNA (PA-C)
Entity Type:Individual
Prefix:MS
First Name:DONNA
Middle Name:
Last Name:WHITMAN
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 1:115 W CLEVELAND ST
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59715-5205
Mailing Address - Country:US
Mailing Address - Phone:406-585-7539
Mailing Address - Fax:
Practice Address - Street 1:115 W CLEVELAND ST
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-5205
Practice Address - Country:US
Practice Address - Phone:406-585-7539
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT164363A00000X
NY23-010594363A00000X
NMPA2006-0032363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant