Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 26NC07884900 | NJ |
NPI | 1396751368 |
---|---|
Provider Name | Linda A Donovan |
First Address | Linwood, NJ 08221-1619 |
Second Address | Atlantic City, NJ 08401-6713 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/07/2006 |
Last Update Date | 08/07/2007 |