Active NPI
Jamie Lynn Donnelly
- Registered Nurse
- Friendship, WI
National Provider Identifier
1801465778
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 155479-30
- Practice address
- 1955 Edgewood Ave
Friendship, WI 53934-9630 - Phone
- (608) 963-9163
- NPI assigned
- Jun 23, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 155479-30 | WI | Primary |
Addresses
Primary practice location
1955 Edgewood Ave
Friendship, WI 53934-9630
Mailing address
1955 Edgewood Ave
Friendship, WI 53934-9630
Phone (608) 963-9163
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 155479-30 | WI | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1624406400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1624406400000",
"number": "1801465778",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1955 EDGEWOOD AVE",
"city": "FRIENDSHIP",
"state": "WI",
"postal_code": "539349630",
"telephone_number": "608-963-9163"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1955 EDGEWOOD AVE",
"city": "FRIENDSHIP",
"state": "WI",
"postal_code": "539349630",
"telephone_number": "608-963-9163"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DONNELLY",
"first_name": "JAMIE",
"middle_name": "LYNN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-06-23",
"last_updated": "2021-06-23",
"certification_date": "2021-06-23",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "WI",
"license": "155479-30",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Friendship, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.