Provider Demographics
NPI:1669485298
Name:DONAVAN, DEBORAH LYNETTE (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:LYNETTE
Last Name:DONAVAN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:418 N SCOTT AVE
Mailing Address - Street 2:
Mailing Address - City:KINSLEY
Mailing Address - State:KS
Mailing Address - Zip Code:67547-1919
Mailing Address - Country:US
Mailing Address - Phone:620-659-3762
Mailing Address - Fax:
Practice Address - Street 1:620 W 8TH
Practice Address - Street 2:
Practice Address - City:KINSLEY
Practice Address - State:KS
Practice Address - Zip Code:67547
Practice Address - Country:US
Practice Address - Phone:620-659-3621
Practice Address - Fax:620-659-3869
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2010-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS45715363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner