Provider Demographics
NPI:1558392902
Name:TEMPLETON, DONNA DAVIS (RN, APN,C, CA)
Entity Type:Individual
Prefix:MS
First Name:DONNA
Middle Name:DAVIS
Last Name:TEMPLETON
Suffix:
Gender:F
Credentials:RN, APN,C, CA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 WINONA TRL
Mailing Address - Street 2:
Mailing Address - City:LAKE HOPATCONG
Mailing Address - State:NJ
Mailing Address - Zip Code:07849-1013
Mailing Address - Country:US
Mailing Address - Phone:973-663-0839
Mailing Address - Fax:
Practice Address - Street 1:40 WATCHUNG WAY
Practice Address - Street 2:
Practice Address - City:BERKELEY HEIGHTS
Practice Address - State:NJ
Practice Address - Zip Code:07922
Practice Address - Country:US
Practice Address - Phone:908-771-5741
Practice Address - Fax:908-771-5744
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NC03643400364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ755948Medicare ID - Type Unspecified
NJPI5101Medicare UPIN