Provider Demographics
NPI:1629743372
Name:MOREHEAD, DONNA L (RN)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:L
Last Name:MOREHEAD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 GERRY RD
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12603-5615
Mailing Address - Country:US
Mailing Address - Phone:216-952-9047
Mailing Address - Fax:
Practice Address - Street 1:32 GERRY RD
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12603-5615
Practice Address - Country:US
Practice Address - Phone:216-952-9047
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-14
Last Update Date:2021-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY531199163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WE0003XNursing Service ProvidersRegistered NurseEmergency