Provider Demographics
NPI:1770570285
Name:DONLEY, CYNTHIA L (PNP)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:L
Last Name:DONLEY
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:9000 W WISCONSIN AVE
Mailing Address - Street 2:MAIL STATION 958
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53226-4874
Mailing Address - Country:US
Mailing Address - Phone:414-266-7615
Mailing Address - Fax:414-266-6238
Practice Address - Street 1:4855 S MOORLAND RD
Practice Address - Street 2:URGENT CARE CLINIC
Practice Address - City:NEW BERLIN
Practice Address - State:WI
Practice Address - Zip Code:53151-7494
Practice Address - Country:US
Practice Address - Phone:262-432-7599
Practice Address - Fax:262-432-7694
Is Sole Proprietor?:No
Enumeration Date:2005-09-29
Last Update Date:2015-03-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI5486-33363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
R166621OtherPTAN
WI1770570285Medicaid
OR108592Medicare ID - Type Unspecified