Provider Demographics
NPI:1831485895
Name:DONEGAN, ANITA SHARYL CLINTON (WHNP)
Entity Type:Individual
Prefix:MRS
First Name:ANITA SHARYL
Middle Name:CLINTON
Last Name:DONEGAN
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1012 BIG LANE DR
Mailing Address - Street 2:
Mailing Address - City:BROOKHAVEN
Mailing Address - State:MS
Mailing Address - Zip Code:39601-2331
Mailing Address - Country:US
Mailing Address - Phone:601-835-3949
Mailing Address - Fax:601-833-1633
Practice Address - Street 1:1012 BIG LANE DR
Practice Address - Street 2:
Practice Address - City:BROOKHAVEN
Practice Address - State:MS
Practice Address - Zip Code:39601-2331
Practice Address - Country:US
Practice Address - Phone:601-835-3949
Practice Address - Fax:601-833-1633
Is Sole Proprietor?:No
Enumeration Date:2011-06-28
Last Update Date:2011-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR854109363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health