Provider Demographics
NPI:1013240621
Name:DONOVAN-BATSON, COLLEEN MOIRA (ARNP, CNM)
Entity Type:Individual
Prefix:
First Name:COLLEEN
Middle Name:MOIRA
Last Name:DONOVAN-BATSON
Suffix:
Gender:F
Credentials:ARNP, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1001
Mailing Address - Street 2:
Mailing Address - City:COLVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:99114-5012
Mailing Address - Country:US
Mailing Address - Phone:509-684-5428
Mailing Address - Fax:
Practice Address - Street 1:144 E 1ST AVE
Practice Address - Street 2:SUITE B
Practice Address - City:COLVILLE
Practice Address - State:WA
Practice Address - Zip Code:99114-2843
Practice Address - Country:US
Practice Address - Phone:509-684-5428
Practice Address - Fax:509-684-5428
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-14
Last Update Date:2012-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60105487367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife