Provider Demographics
NPI:1255571782
Name:DONAHUE, KERRI ANN (CRNP)
Entity type:Individual
Prefix:
First Name:KERRI
Middle Name:ANN
Last Name:DONAHUE
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:KERRI
Other - Middle Name:ANN
Other - Last Name:MEENAGH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:101 E OLNEY AVE
Mailing Address - Street 2:STE 400
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19120-2470
Mailing Address - Country:US
Mailing Address - Phone:215-456-1825
Mailing Address - Fax:215-456-5926
Practice Address - Street 1:6129 COLGATE ST
Practice Address - Street 2:
Practice Address - City:PHILA
Practice Address - State:PA
Practice Address - Zip Code:19111-6006
Practice Address - Country:US
Practice Address - Phone:215-725-2341
Practice Address - Fax:215-927-7939
Is Sole Proprietor?:No
Enumeration Date:2009-02-24
Last Update Date:2020-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP006170D363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics