Provider Demographics
NPI:1922336601
Name:DONOHO, AMY
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:DONOHO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1819 S COURT ST
Mailing Address - Street 2:
Mailing Address - City:FERGUS FALLS
Mailing Address - State:MN
Mailing Address - Zip Code:56537-3642
Mailing Address - Country:US
Mailing Address - Phone:218-739-9438
Mailing Address - Fax:
Practice Address - Street 1:615 S MILL ST
Practice Address - Street 2:SUITE 2
Practice Address - City:FERGUS FALLS
Practice Address - State:MN
Practice Address - Zip Code:56537-2756
Practice Address - Country:US
Practice Address - Phone:218-998-2020
Practice Address - Fax:218-998-2098
Is Sole Proprietor?:No
Enumeration Date:2009-11-18
Last Update Date:2009-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN144642156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN4C854DOOtherBLUE CROSS BLUE SHIELD OF MN