Provider Demographics
NPI:1598139230
Name:DUMPSON, DONISE PAULLETTE (CRNA)
Entity Type:Individual
Prefix:MS
First Name:DONISE
Middle Name:PAULLETTE
Last Name:DUMPSON
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:616 CHELTON AVE
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08104-2221
Mailing Address - Country:US
Mailing Address - Phone:856-577-6900
Mailing Address - Fax:
Practice Address - Street 1:140 MT. HOLLY BYPASS
Practice Address - Street 2:
Practice Address - City:LUMBERTON
Practice Address - State:NJ
Practice Address - Zip Code:08048
Practice Address - Country:US
Practice Address - Phone:609-267-1555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-18
Last Update Date:2015-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR12397500367500000X
PARN628787367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered