Provider Demographics
NPI:1619521978
Name:ANDERSON, DONNA JEAN (DNP FNP-BC)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:JEAN
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:DNP FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:170 UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:MA
Mailing Address - Zip Code:01002-2247
Mailing Address - Country:US
Mailing Address - Phone:413-461-3530
Mailing Address - Fax:413-461-3532
Practice Address - Street 1:170 UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:MA
Practice Address - Zip Code:01002-2247
Practice Address - Country:US
Practice Address - Phone:413-461-3530
Practice Address - Fax:413-461-3532
Is Sole Proprietor?:No
Enumeration Date:2019-07-25
Last Update Date:2019-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2266161363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily