Provider Demographics
NPI:1598103681
Name:CUTSHALL, DONNA (CNM)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:CUTSHALL
Suffix:
Gender:F
Credentials:CNM
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Other - First Name:
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Mailing Address - Street 1:2920 S MCINTIRE DR
Mailing Address - Street 2:SUITE 250
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47403-4221
Mailing Address - Country:US
Mailing Address - Phone:812-332-9217
Mailing Address - Fax:812-330-4474
Practice Address - Street 1:2920 S MCINTIRE DR
Practice Address - Street 2:SUITE 250
Practice Address - City:BLOOMINGTON
Practice Address - State:IN
Practice Address - Zip Code:47403-4221
Practice Address - Country:US
Practice Address - Phone:812-332-9217
Practice Address - Fax:812-330-4474
Is Sole Proprietor?:No
Enumeration Date:2013-06-11
Last Update Date:2023-07-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN09000229A367A00000X
71004429A367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201189270Medicaid