Provider Demographics
NPI:1619043064
Name:DONATO, ANNEMARIE SIPKES (APRN)
Entity Type:Individual
Prefix:MRS
First Name:ANNEMARIE
Middle Name:SIPKES
Last Name:DONATO
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Gender:F
Credentials:APRN
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Mailing Address - Street 1:1624 MAIN STREET
Mailing Address - Street 2:AGAPE SENIOR PRIMARY CARE, INC., DBA LTC HEALTH SOLUTIO
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29201-2818
Mailing Address - Country:US
Mailing Address - Phone:803-726-2350
Mailing Address - Fax:803-404-6000
Practice Address - Street 1:9302 MEDICAL PLAZA DRIVE SUITE C
Practice Address - Street 2:LTC HEALTH SOLUTIONS
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29406
Practice Address - Country:US
Practice Address - Phone:843-797-0416
Practice Address - Fax:843-847-4477
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2017-03-15
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Provider Licenses
StateLicense IDTaxonomies
SCF2490363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCNPO374Medicaid