Provider Demographics
NPI:1841011590
Name:DONAHUE, LADEIDRA (NRCMA, NRCPT)
Entity type:Individual
Prefix:MRS
First Name:LADEIDRA
Middle Name:
Last Name:DONAHUE
Suffix:
Gender:F
Credentials:NRCMA, NRCPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10515 W MARKHAM ST STE I3
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-2283
Mailing Address - Country:US
Mailing Address - Phone:501-492-6797
Mailing Address - Fax:501-307-1259
Practice Address - Street 1:10515 W MARKHAM ST STE I3
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-2283
Practice Address - Country:US
Practice Address - Phone:501-492-6797
Practice Address - Fax:501-307-1259
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-24
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR168912246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy