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Individual

LEAH TAYLOR DONOVAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
R.N., A.P.N.P.

Contact information

Practice address
375 W RIVER WOODS PKWY, SUITE 205, GLENDALE, WI 53212-1080
(414) 961-7250
(414) 961-2795
Mailing address
4425 N PORT WASHINGTON RD, ATTN: CSMCP CLINIC CREDENTIALING, GLENDALE, WI 53212-1082
(414) 961-7250
(414) 961-2795

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2570-033
WI

Other

Enumeration date
09/26/2006
Last updated
11/15/2011
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