Individual provider Active NPI

Deborah Lynette Donavan, ARNP

  • Nurse Practitioner
  • Kinsley, KS
National Provider Identifier
1669485298
Registry record updated Apr 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
45715 Issued in KS
Practice address
620 W 8TH
Kinsley, KS 67547
Phone
(620) 659-3621
Fax
(620) 659-3869
NPI assigned
Aug 14, 2006
Last updated
Apr 29, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 45715 KS Primary

Addresses

Primary practice location

620 W 8TH
Kinsley, KS 67547

Mailing address

418 N Scott Ave
Kinsley, KS 67547-1919
Phone (620) 659-3762

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050714000109 KS Practitioner - Nurse Practitioner 2062448772

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
45715KSMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1272499200000",
    "number": "1669485298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "418 N SCOTT AVE",
            "city": "KINSLEY",
            "state": "KS",
            "postal_code": "675471919",
            "telephone_number": "620-659-3762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 W 8TH",
            "city": "KINSLEY",
            "state": "KS",
            "postal_code": "67547",
            "telephone_number": "620-659-3621",
            "fax_number": "620-659-3869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONAVAN",
        "first_name": "DEBORAH",
        "middle_name": "LYNETTE",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-14",
        "last_updated": "2010-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KS",
            "license": "45715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kinsley, KS

Sources for this page

Verify at the official NPI Registry.