Provider Demographics
NPI:1285715805
Name:NEWKIRK, DONNA MARIE (APRN-BC)
Entity type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:MARIE
Last Name:NEWKIRK
Suffix:
Gender:F
Credentials:APRN-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1363 W SPRUCE AVE
Mailing Address - Street 2:
Mailing Address - City:WASILLA
Mailing Address - State:AK
Mailing Address - Zip Code:99654-5327
Mailing Address - Country:US
Mailing Address - Phone:907-376-2411
Mailing Address - Fax:907-352-3301
Practice Address - Street 1:904 PEGASUS CT
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80537-3248
Practice Address - Country:US
Practice Address - Phone:970-744-8812
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2020-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK660363LF0000X
COAPN.0993906-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK1533158OtherMEDICARE ID
AKB003OtherTRICARE, PAYER ID #CH003
AKNP06602Medicaid
AKNP06602Medicaid
AK1533158OtherMEDICARE ID