Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 403118 | NY |
NPI | 1013548361 |
---|---|
Provider Name | Corinna Marie Donner |
First Address | Niagara Falls, NY 14304-1422 |
Second Address | Cheektowaga, NY 14225-1954 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/01/2020 |
Last Update Date | 14/08/2020 |