Provider Demographics
NPI:1952380701
Name:DONNAY, JEAN MARIE (APRN CNP)
Entity Type:Individual
Prefix:
First Name:JEAN
Middle Name:MARIE
Last Name:DONNAY
Suffix:
Gender:F
Credentials:APRN CNP
Other - Prefix:
Other - First Name:JEAN
Other - Middle Name:
Other - Last Name:DONNAY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NP
Mailing Address - Street 1:1360 ELM STREET EAST
Mailing Address - Street 2:CENTRACARE CLINIC
Mailing Address - City:ST JOSEPH
Mailing Address - State:MN
Mailing Address - Zip Code:56374-4694
Mailing Address - Country:US
Mailing Address - Phone:320-363-7765
Mailing Address - Fax:320-363-0031
Practice Address - Street 1:1360 ELM STREET EAST
Practice Address - Street 2:CENTRACARE CLINIC
Practice Address - City:ST JOSEPH
Practice Address - State:MN
Practice Address - Zip Code:56374-4694
Practice Address - Country:US
Practice Address - Phone:320-363-7765
Practice Address - Fax:320-363-0031
Is Sole Proprietor?:No
Enumeration Date:2006-01-11
Last Update Date:2015-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR0673592363LA2200X
MNCNP2431363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN163042300Medicaid