Provider Demographics
NPI:1730100165
Name:COLLIGAN, DONNA EPSTEIN (ARNP)
Entity Type:Individual
Prefix:MS
First Name:DONNA
Middle Name:EPSTEIN
Last Name:COLLIGAN
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 1:10812 BUTTONWOOD LAKE DR
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33498-1682
Mailing Address - Country:US
Mailing Address - Phone:561-400-1563
Mailing Address - Fax:
Practice Address - Street 1:3848 FAU BLVD STE 210
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-6437
Practice Address - Country:US
Practice Address - Phone:561-394-3088
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2016-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1559432363L00000X
FLARNP1559432363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY028BOtherBLUE SHIELD
FL500023321OtherRR MEDICARE
FL305535300Medicaid
FLE1068VMedicare PIN
P32674Medicare UPIN
FLE1068WMedicare ID - Type Unspecified
FLE1068YMedicare ID - Type Unspecified
FL305535300Medicaid
FLE1068ZMedicare ID - Type Unspecified