Provider Demographics
NPI:1740432392
Name:COMETA, DONNA JEAN (RN)
Entity Type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:JEAN
Last Name:COMETA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MISS
Other - First Name:DONNA
Other - Middle Name:JEAN
Other - Last Name:WINANS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:P.O. BOX 23
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:NY
Mailing Address - Zip Code:14711
Mailing Address - Country:US
Mailing Address - Phone:585-365-2908
Mailing Address - Fax:
Practice Address - Street 1:6745 ROUTE 305
Practice Address - Street 2:
Practice Address - City:BELFAST
Practice Address - State:NY
Practice Address - Zip Code:14711
Practice Address - Country:US
Practice Address - Phone:585-365-2908
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-15
Last Update Date:2008-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY405306-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse