Provider Demographics
NPI:1215177134
Name:DONATO, DANIELLE MARIE (CNM)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:MARIE
Last Name:DONATO
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1019 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:WEST LONG BRANCH
Mailing Address - State:NJ
Mailing Address - Zip Code:07764-1326
Mailing Address - Country:US
Mailing Address - Phone:732-229-6797
Mailing Address - Fax:
Practice Address - Street 1:1019 BROADWAY
Practice Address - Street 2:
Practice Address - City:WEST LONG BRANCH
Practice Address - State:NJ
Practice Address - Zip Code:07764-1326
Practice Address - Country:US
Practice Address - Phone:732-229-6797
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-05
Last Update Date:2022-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024168177363LW0102X
NJ25ME00057301363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health