Provider Demographics
NPI:1881688414
Name:DAMRON, DONNA S (APRN)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:S
Last Name:DAMRON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 ROSE STREET, C213 UKMC
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40536-0293
Mailing Address - Country:US
Mailing Address - Phone:859-388-4281
Mailing Address - Fax:
Practice Address - Street 1:800 ROSE STREET, C213 UKMC
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-0293
Practice Address - Country:US
Practice Address - Phone:859-388-4281
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-09
Last Update Date:2020-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3003024363L00000X, 363LF0000X
KY3024P363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY3003024OtherLICENSE
KY78008513Medicaid
P02322Medicare UPIN
KY0258117Medicare ID - Type Unspecified
KY78008513Medicaid
KY0253423Medicare ID - Type Unspecified
KY0396114Medicare ID - Type Unspecified