Provider Demographics
NPI:1336523836
Name:DONAUGH, WENDY LEE (FNP)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:LEE
Last Name:DONAUGH
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:#2 SUNFLOWER LN
Mailing Address - Street 2:
Mailing Address - City:PARK CITY
Mailing Address - State:MT
Mailing Address - Zip Code:59063
Mailing Address - Country:US
Mailing Address - Phone:406-850-0893
Mailing Address - Fax:
Practice Address - Street 1:2409 ARNOLD LN STE 9
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-3885
Practice Address - Country:US
Practice Address - Phone:406-345-5314
Practice Address - Fax:747-205-0742
Is Sole Proprietor?:No
Enumeration Date:2015-07-14
Last Update Date:2022-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT100515207RR0500X
MTRN28625363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT1336523536Medicaid