Provider Demographics
NPI:1750455929
Name:LAUE, DONNA (NP)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:LAUE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:803 N JEFFERSON ST STE A
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31701-5117
Mailing Address - Country:US
Mailing Address - Phone:229-312-7600
Mailing Address - Fax:
Practice Address - Street 1:803 N JEFFERSON ST STE C
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31701-5117
Practice Address - Country:US
Practice Address - Phone:229-312-5800
Practice Address - Fax:229-312-5853
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN095679163WW0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WW0000XNursing Service ProvidersRegistered NurseWound Care