Provider Demographics
NPI:1528640703
Name:DONATHAN, ERIC THOMAS (MSN, APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:THOMAS
Last Name:DONATHAN
Suffix:
Gender:M
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 LAMOTTE DR APT C1
Mailing Address - Street 2:
Mailing Address - City:HILTON HEAD
Mailing Address - State:SC
Mailing Address - Zip Code:29926-2722
Mailing Address - Country:US
Mailing Address - Phone:304-639-8624
Mailing Address - Fax:
Practice Address - Street 1:2 MARSHLAND RD
Practice Address - Street 2:
Practice Address - City:HILTON HEAD
Practice Address - State:SC
Practice Address - Zip Code:29926-2305
Practice Address - Country:US
Practice Address - Phone:843-842-2900
Practice Address - Fax:843-842-8017
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-27
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC24915363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC24915OtherAPRN LICENSE