Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | RN274826 | MA |
Y | 363LN0000X | Nurse Practitioner - Neonatal | 062322-23 | NH |
N | 363LN0000X | Nurse Practitioner - Neonatal | RN274826 | MA |
N | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | RN274826 | MA |
NPI | 1295057917 |
---|---|
Provider Name | Mrs. Donna D Mann |
First Address | Manchester, NH 03102-3730 |
Second Address | Manchester, NH 03102-3730 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/02/2010 |
Last Update Date | 30/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
110104057A | (05) | MA |
30348035 | (05) | NH |