Provider Demographics
NPI:1205483435
Name:DONAGHY, CATHERINE A (APRNCNP)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:A
Last Name:DONAGHY
Suffix:
Gender:F
Credentials:APRNCNP
Other - Prefix:
Other - First Name:CATHERINE
Other - Middle Name:
Other - Last Name:MUDD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1 PRESTIGE PL STE 550
Mailing Address - Street 2:
Mailing Address - City:MIAMISBURG
Mailing Address - State:OH
Mailing Address - Zip Code:45342-6115
Mailing Address - Country:US
Mailing Address - Phone:937-762-1310
Mailing Address - Fax:937-522-8493
Practice Address - Street 1:405 W GRAND AVE
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45405-7538
Practice Address - Country:US
Practice Address - Phone:937-723-3276
Practice Address - Fax:937-723-3277
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-22
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.347058163W00000X
OHAPRN.CNP.025975363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0380709Medicaid