Provider Demographics
NPI:1467686014
Name:DUVALL, DONNA SUSANN (NP)
Entity type:Individual
Prefix:MS
First Name:DONNA
Middle Name:SUSANN
Last Name:DUVALL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
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Mailing Address - Street 1:7969 SENTINEL
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92127-2569
Mailing Address - Country:US
Mailing Address - Phone:858-759-6956
Mailing Address - Fax:858-759-6956
Practice Address - Street 1:9850 GENESEE AVE
Practice Address - Street 2:SUITE 640
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-1224
Practice Address - Country:US
Practice Address - Phone:858-677-0777
Practice Address - Fax:858-677-0666
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-12
Last Update Date:2009-05-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA14690363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health