Provider Demographics
NPI:1962617019
Name:LAMKE, DONNA (MSN)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:LAMKE
Suffix:
Gender:F
Credentials:MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2021 RIDLEY AVE
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95403-2484
Mailing Address - Country:US
Mailing Address - Phone:707-527-1025
Mailing Address - Fax:
Practice Address - Street 1:1370 MEDICAL CENTER DR STE E
Practice Address - Street 2:
Practice Address - City:ROHNERT PARK
Practice Address - State:CA
Practice Address - Zip Code:94928-2934
Practice Address - Country:US
Practice Address - Phone:707-584-3524
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA6931363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily