Provider Demographics
NPI:1063880847
Name:MALCHANO, DONNA (CRNP)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:MALCHANO
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:DONNA
Other - Middle Name:
Other - Last Name:KALTENBAUGH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:50 S B B KING BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38103-9802
Mailing Address - Country:US
Mailing Address - Phone:901-436-1381
Mailing Address - Fax:
Practice Address - Street 1:700 BOWER HILL RD STE 6206
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15243-2040
Practice Address - Country:US
Practice Address - Phone:412-627-5302
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-10
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP014712363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily