Provider Demographics
NPI:1558771717
Name:NAGLE, DONNA (HIS)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:NAGLE
Suffix:
Gender:F
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10002 FRIERSON LAKE DR
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:FL
Mailing Address - Zip Code:34669-3401
Mailing Address - Country:US
Mailing Address - Phone:727-858-3563
Mailing Address - Fax:727-239-4576
Practice Address - Street 1:10002 FRIERSON LAKE DR
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:FL
Practice Address - Zip Code:34669-3401
Practice Address - Country:US
Practice Address - Phone:727-858-3563
Practice Address - Fax:727-239-4576
Is Sole Proprietor?:No
Enumeration Date:2014-04-28
Last Update Date:2014-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAS4603237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist