Provider Demographics
NPI:1992707574
Name:ST. PIERRE, DONNA M (CRNA)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:M
Last Name:ST. PIERRE
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 PARADISE LAKE RD
Mailing Address - Street 2:P O BOX 385
Mailing Address - City:MONSON
Mailing Address - State:MA
Mailing Address - Zip Code:01057-9727
Mailing Address - Country:US
Mailing Address - Phone:413-267-3947
Mailing Address - Fax:413-267-9583
Practice Address - Street 1:171 INTERSTATE DR
Practice Address - Street 2:
Practice Address - City:WEST SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01089-5101
Practice Address - Country:US
Practice Address - Phone:413-737-5500
Practice Address - Fax:413-732-3514
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA85884367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
MANA0315Medicare ID - Type Unspecified