Lee Ann Hertzog Donovan, CPNP

Primary specialty

Pediatric Registered NurseTaxonomy code 163WP0200X

License

R1497120 Issued in MN

Practice address

250 N Central Ave
#101
Wayzata, MN 55391

Phone

(952) 473-0211

Fax

(952) 473-7908

NPI assigned

Feb 7, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Lee Ann Hertzog Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Pediatric Nurse Practitioner

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Wayzata Children'S Clinic P.a.

  • Pediatrics Physician
  • Minnetonka, MN
  • NPI 1023081577
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1139270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1376516831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N CENTRAL AVE",
            "address_2": "#101",
            "city": "WAYZATA",
            "state": "MN",
            "postal_code": "55391",
            "telephone_number": "952-473-0211",
            "fax_number": "952-473-7908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 N CENTRAL AVE",
            "address_2": "#101",
            "city": "WAYZATA",
            "state": "MN",
            "postal_code": "55391",
            "telephone_number": "952-473-0211",
            "fax_number": "952-473-7908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERTZOG DONOVAN",
        "first_name": "LEE",
        "middle_name": "ANN",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-07",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "MN",
            "license": "R1497120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LEE",
            "last_name": "HERTZOG",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Timothy P Haupert, O.D.
• Healing Roots Counseling
• Healthtouch Home Care, Inc.
• Darlene Heimerl, M.A.
• Julia Ann Herman, D.D.S
• Erica L Hertzog, PHN
• Jonathan Hess
• Hillcrest of Wayzatta Operations LLC
• Barbara Joanne Hilleren, MA, LP
• Harry Mark Hoberman, PH.D.

• Pediatric Registered Nurse in Wayzata, MN
• Providers in Wayzata, MN by specialty
• Pediatric Registered Nurse in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.