Provider Demographics
NPI:1609278035
Name:DONAHUE, FRIEDA MARIE
Entity Type:Individual
Prefix:
First Name:FRIEDA
Middle Name:MARIE
Last Name:DONAHUE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:728 SAINT CLAIR AVE
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16505-3445
Mailing Address - Country:US
Mailing Address - Phone:814-873-9568
Mailing Address - Fax:
Practice Address - Street 1:728 SAINT CLAIR AVE
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16505-3445
Practice Address - Country:US
Practice Address - Phone:814-873-9568
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-17
Last Update Date:2014-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPN293386164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse