Provider Demographics
NPI:1386071348
Name:MATHEWS HOLMAN, DONNA LEE (FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:LEE
Last Name:MATHEWS HOLMAN
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7496
Mailing Address - Street 2:
Mailing Address - City:KETCHIKAN
Mailing Address - State:AK
Mailing Address - Zip Code:99901-2496
Mailing Address - Country:US
Mailing Address - Phone:907-617-0082
Mailing Address - Fax:907-225-5753
Practice Address - Street 1:700 WATER ST
Practice Address - Street 2:
Practice Address - City:KETCHIKAN
Practice Address - State:AK
Practice Address - Zip Code:99901-6141
Practice Address - Country:US
Practice Address - Phone:907-225-5753
Practice Address - Fax:907-225-5753
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-03
Last Update Date:2013-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK1395363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily