Provider Demographics
NPI:1790387447
Name:DONNELLY, NATASHA JANE (RN, PHD, PMHNP-BC)
Entity Type:Individual
Prefix:DR
First Name:NATASHA
Middle Name:JANE
Last Name:DONNELLY
Suffix:
Gender:F
Credentials:RN, PHD, PMHNP-BC
Other - Prefix:
Other - First Name:NATASHA
Other - Middle Name:JANE
Other - Last Name:DONNELLY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ROBERTS
Mailing Address - Street 1:2937 HORSE SHOE FARM RD
Mailing Address - Street 2:
Mailing Address - City:WAKE FOREST
Mailing Address - State:NC
Mailing Address - Zip Code:27587-6724
Mailing Address - Country:US
Mailing Address - Phone:919-830-6711
Mailing Address - Fax:
Practice Address - Street 1:MONARCH BEHAVIORAL HEALTH URGENT CARE
Practice Address - Street 2:319 CHAPANOKE ROAD, STE 120
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27603-2758
Practice Address - Country:US
Practice Address - Phone:919-703-2845
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-09
Last Update Date:2021-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC237757163W00000X
NC5013953363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse