Provider Demographics
NPI:1316078264
Name:BARTOW, DONNA
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:BARTOW
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:W9907 619TH AVE
Mailing Address - Street 2:
Mailing Address - City:ELLSWORTH
Mailing Address - State:WI
Mailing Address - Zip Code:54011
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1953 UNIVERSITY AVE W
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55104-3427
Practice Address - Country:US
Practice Address - Phone:651-659-0208
Practice Address - Fax:651-659-0161
Is Sole Proprietor?:No
Enumeration Date:2007-03-09
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR 170234-9163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN4J19CAOtherBCBS
MN181585OtherUCARE MN PCA
MN37865OtherHEALTHPARTNERS
MN106205OtherUCARE MN
MN5900010OtherMEDICA
MN37865OtherHEALTHPARTNERS