Individual
KELLY ANN DONAHUE
Active
Individual
KELLY ANN DONAHUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
RT004717
PA
363AM0700X
Medical Physician Assistant
0110-004647
VA
363AS0400X
Surgical Physician Assistant
Primary
PA031054
DC
Other
Enumeration date
07/30/2014
Last updated
07/19/2015
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