Provider Demographics
NPI:1861428344
Name:DONIGAN, ELIZABETH A (CRNP)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:A
Last Name:DONIGAN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1413 COLUMBUS RD
Mailing Address - Street 2:
Mailing Address - City:DEMING
Mailing Address - State:NM
Mailing Address - Zip Code:88030-5251
Mailing Address - Country:US
Mailing Address - Phone:575-546-6548
Mailing Address - Fax:575-546-6540
Practice Address - Street 1:905 S 8TH ST STE B
Practice Address - Street 2:
Practice Address - City:DEMING
Practice Address - State:NM
Practice Address - Zip Code:88030-4037
Practice Address - Country:US
Practice Address - Phone:575-543-7200
Practice Address - Fax:575-546-6540
Is Sole Proprietor?:No
Enumeration Date:2006-06-24
Last Update Date:2023-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 9216691363LX0001X
NMR66903363LX0001X
PASP007054363LX0001X
NMCNP01470363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology