Provider Demographics
NPI:1942914478
Name:EVERLY, DONNA ANNE (LPN)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:ANNE
Last Name:EVERLY
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:DONNA
Other - Middle Name:
Other - Last Name:DESSECKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:301 SMITH DR STE 3
Mailing Address - Street 2:
Mailing Address - City:CRANBERRY TWP
Mailing Address - State:PA
Mailing Address - Zip Code:16066-4131
Mailing Address - Country:US
Mailing Address - Phone:724-779-2010
Mailing Address - Fax:
Practice Address - Street 1:301 SMITH DR STE 3
Practice Address - Street 2:
Practice Address - City:CRANBERRY TWP
Practice Address - State:PA
Practice Address - Zip Code:16066-4131
Practice Address - Country:US
Practice Address - Phone:724-779-2010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-10
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPN312652164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse