Individual
KENYA EARNESSA DONOVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
KENYA
Contact information
Practice address
204 E COLLEGE ST, BRIDGEWATER, VA 22812-1507
(917) 653-3425
Mailing address
1087 WOODBURY CIR APT 104, HARRISONBURG, VA 22802-2660
(917) 653-3425
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NA
NOT NEEDED
NJ
Enumeration date
09/02/2019
Last updated
09/02/2019
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