Provider Demographics
NPI:1568427409
Name:BRIAN, DONNA L (CRNP)
Entity Type:Individual
Prefix:DR
First Name:DONNA
Middle Name:L
Last Name:BRIAN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1035 W BERKS ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19122-1909
Mailing Address - Country:US
Mailing Address - Phone:215-765-6690
Mailing Address - Fax:215-765-6694
Practice Address - Street 1:1035 W BERKS ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19122-1909
Practice Address - Country:US
Practice Address - Phone:215-765-6690
Practice Address - Fax:215-765-6694
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2011-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATP001559G363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA30027028OtherKEYSTONE MERCY HEALTH PLAN
PA0016148810001Medicaid
PA2268261000OtherKEYSTONE HEALTH PLAN EAST
PA1488022OtherAETNA
PA1590244OtherBLUE CROSS & BLUE SHIELD
PA17667OtherBRAVO HEALTH