Provider Demographics
NPI:1639310667
Name:DONNER, WAYNE H (RN)
Entity Type:Individual
Prefix:MR
First Name:WAYNE
Middle Name:H
Last Name:DONNER
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 THUNDER RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:RUSH
Mailing Address - State:NY
Mailing Address - Zip Code:14543-9422
Mailing Address - Country:US
Mailing Address - Phone:585-533-1959
Mailing Address - Fax:
Practice Address - Street 1:51 THUNDER RIDGE DR
Practice Address - Street 2:
Practice Address - City:RUSH
Practice Address - State:NY
Practice Address - Zip Code:14543-9422
Practice Address - Country:US
Practice Address - Phone:585-533-1959
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-21
Last Update Date:2009-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY576745-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse