Individual
MAURISSA DONANGELO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C, PHD
Contact information
Practice address
526 SHOUP AVE W STE E, TWIN FALLS, ID 83301-5050
(208) 736-3362
(208) 736-3382
Mailing address
1969 9TH AVE E, TWIN FALLS, ID 83301-6707
(801) 712-1621
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-1970
ID
363A00000X
Physician Assistant
—
—
Other
Enumeration date
05/04/2018
Last updated
02/22/2023
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