Provider Demographics
NPI:1639242738
Name:SCHIMMELPFENNIGWALDO, DONNA ANN (RN, MN, FNP)
Entity Type:Individual
Prefix:MS
First Name:DONNA
Middle Name:ANN
Last Name:SCHIMMELPFENNIGWALDO
Suffix:
Gender:F
Credentials:RN, MN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2900 LEMAY FERRY RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63125-3900
Mailing Address - Country:US
Mailing Address - Phone:314-892-3500
Mailing Address - Fax:314-892-2523
Practice Address - Street 1:2900 LEMAY FERRY RD
Practice Address - Street 2:SUITE 100
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63125-3900
Practice Address - Country:US
Practice Address - Phone:314-892-3500
Practice Address - Fax:314-892-2523
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2008-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO087953363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO087953OtherFNP LICENSE