Provider Demographics
NPI:1174560114
Name:PRICE, DONNA (PA-C)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:PRICE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2999 PRESIDENTIAL BLVD
Mailing Address - Street 2:
Mailing Address - City:HERMITAGE
Mailing Address - State:PA
Mailing Address - Zip Code:16148-3689
Mailing Address - Country:US
Mailing Address - Phone:724-983-1800
Mailing Address - Fax:724-983-0856
Practice Address - Street 1:2999 PRESIDENTIAL BLVD
Practice Address - Street 2:
Practice Address - City:HERMITAGE
Practice Address - State:PA
Practice Address - Zip Code:16148-3689
Practice Address - Country:US
Practice Address - Phone:724-983-1800
Practice Address - Fax:724-983-0856
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA001142L363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical