Provider Demographics
NPI:1609048081
Name:DONEGAN, COLLEEN A (ND, RN)
Entity Type:Individual
Prefix:DR
First Name:COLLEEN
Middle Name:A
Last Name:DONEGAN
Suffix:
Gender:F
Credentials:ND, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:945 LYLE YOUNG RD
Mailing Address - Street 2:
Mailing Address - City:EAST MONTPELIER
Mailing Address - State:VT
Mailing Address - Zip Code:05651-4091
Mailing Address - Country:US
Mailing Address - Phone:802-223-6347
Mailing Address - Fax:
Practice Address - Street 1:28 SCHOOL ST
Practice Address - Street 2:SUITE #6
Practice Address - City:MONTPELIER
Practice Address - State:VT
Practice Address - Zip Code:05602-3166
Practice Address - Country:US
Practice Address - Phone:802-262-6078
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-26
Last Update Date:2008-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT026-0023071163WE0003X
VT099-0000228175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No163WE0003XNursing Service ProvidersRegistered NurseEmergency