Provider Demographics
NPI:1912570235
Name:CROSS, DONNA MARIE (NP)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:MARIE
Last Name:CROSS
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:2375 WALL ST SE STE 240
Mailing Address - Street 2:
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30013-2296
Mailing Address - Country:US
Mailing Address - Phone:770-679-4567
Mailing Address - Fax:470-945-4988
Practice Address - Street 1:2375 WALL ST SE STE 240
Practice Address - Street 2:
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30013-2296
Practice Address - Country:US
Practice Address - Phone:770-679-4567
Practice Address - Fax:470-945-4988
Is Sole Proprietor?:No
Enumeration Date:2021-07-23
Last Update Date:2024-06-20
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Provider Licenses
StateLicense IDTaxonomies
GA2019077341363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health