Provider Demographics
NPI:1265239354
Name:DONSA, ISSAKA
Entity type:Individual
Prefix:
First Name:ISSAKA
Middle Name:
Last Name:DONSA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8112 S 92ND AVE
Mailing Address - Street 2:
Mailing Address - City:LA VISTA
Mailing Address - State:NE
Mailing Address - Zip Code:68128-3203
Mailing Address - Country:US
Mailing Address - Phone:929-436-6518
Mailing Address - Fax:
Practice Address - Street 1:8112 S 92ND AVE
Practice Address - Street 2:
Practice Address - City:LA VISTA
Practice Address - State:NE
Practice Address - Zip Code:68128-3203
Practice Address - Country:US
Practice Address - Phone:929-436-6518
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-26
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor