Provider Demographics
NPI:1902861891
Name:MICHAUD, DONNA JEAN (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:JEAN
Last Name:MICHAUD
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5606 W NORVELL BRYANT HWY
Mailing Address - Street 2:
Mailing Address - City:CRYSTAL RIVER
Mailing Address - State:FL
Mailing Address - Zip Code:34429-7572
Mailing Address - Country:US
Mailing Address - Phone:352-795-9266
Mailing Address - Fax:352-795-4879
Practice Address - Street 1:5606 W NORVELL BRYANT HWY
Practice Address - Street 2:
Practice Address - City:CRYSTAL RIVER
Practice Address - State:FL
Practice Address - Zip Code:34429-7572
Practice Address - Country:US
Practice Address - Phone:352-795-9266
Practice Address - Fax:352-795-4879
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9225024363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY080KOtherBLUE CROSS/BLUE SHIELD
FLP00265603OtherRAIL ROAD MEDICARE
FLS28597Medicare UPIN
FLP00265603OtherRAIL ROAD MEDICARE