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Individual
MR. DONNIE R WAITS
Active
Individual
MR. DONNIE R WAITS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN, PDN, A.S.
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
310806
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03522227
—
NY
Enumeration date
11/20/2012
Last updated
12/22/2016
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