Provider Demographics
NPI:1285754184
Name:DONALDSON, MARTHANNE (ANP)
Entity type:Individual
Prefix:MS
First Name:MARTHANNE
Middle Name:
Last Name:DONALDSON
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1325 CHURCHILL ST
Mailing Address - Street 2:
Mailing Address - City:PITTSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01201-1229
Mailing Address - Country:US
Mailing Address - Phone:413-443-3278
Mailing Address - Fax:
Practice Address - Street 1:165 TOR CT
Practice Address - Street 2:HILLCREST CAMPUS OCCUPATIONAL HEALTH DEPT
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201-3001
Practice Address - Country:US
Practice Address - Phone:413-395-7809
Practice Address - Fax:413-445-9571
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA134530363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAMA134530OtherMASS LICENSE