Provider Demographics
NPI:1750686408
Name:ORTA BAPTISTA, DONNA K (LPN)
Entity Type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:K
Last Name:ORTA BAPTISTA
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:317 30TH ST
Mailing Address - Street 2:313D
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OR
Mailing Address - Zip Code:97478-5866
Mailing Address - Country:US
Mailing Address - Phone:541-537-4997
Mailing Address - Fax:
Practice Address - Street 1:317 30TH ST
Practice Address - Street 2:313D
Practice Address - City:SPRINGFIELD
Practice Address - State:OR
Practice Address - Zip Code:97478-5866
Practice Address - Country:US
Practice Address - Phone:541-537-4997
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-11
Last Update Date:2011-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201020440LPN164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse