Provider Demographics
NPI:1609833326
Name:LABUS, DONNETTE ANN (APRN)
Entity Type:Individual
Prefix:MRS
First Name:DONNETTE
Middle Name:ANN
Last Name:LABUS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 S HERLONG AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29732-8349
Mailing Address - Country:US
Mailing Address - Phone:803-909-3600
Mailing Address - Fax:803-909-3800
Practice Address - Street 1:410 S HERLONG AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-8349
Practice Address - Country:US
Practice Address - Phone:803-909-3600
Practice Address - Fax:803-909-3800
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC185310363LF0000X
SC2172363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2593175Medicare UPIN
SCS83425Medicare UPIN