Provider Demographics
NPI:1437104692
Name:PRICE, DONNA S (ARNP)
Entity type:Individual
Prefix:MS
First Name:DONNA
Middle Name:S
Last Name:PRICE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 UNIVERSITY BLVD. NORTH
Mailing Address - Street 2:MC 75
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32211
Mailing Address - Country:US
Mailing Address - Phone:904-253-2062
Mailing Address - Fax:904-253-1942
Practice Address - Street 1:5300 NORTH PEARL STREET
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32208
Practice Address - Country:US
Practice Address - Phone:904-353-2130
Practice Address - Fax:904-353-2131
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2013-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1064692363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL033442100Medicaid
FL0334421-00Medicaid
FLY6511ZMedicare PIN
P18377Medicare UPIN