Provider Demographics
NPI:1245271022
Name:CHILDERS, DONNA FAYE (FNP)
Entity type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:FAYE
Last Name:CHILDERS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:420 E 2ND AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:ROME
Mailing Address - State:GA
Mailing Address - Zip Code:30161-3224
Mailing Address - Country:US
Mailing Address - Phone:706-509-3000
Mailing Address - Fax:706-509-3271
Practice Address - Street 1:420 E 2ND AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:ROME
Practice Address - State:GA
Practice Address - Zip Code:30161-3224
Practice Address - Country:US
Practice Address - Phone:706-509-3000
Practice Address - Fax:706-509-3271
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-10
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GARN097177363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care