Provider Demographics
NPI:1902046568
Name:BURGMAYER, DONNA GREEN (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:GREEN
Last Name:BURGMAYER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 PENN BOULEVARD
Mailing Address - Street 2:SUITE 3026
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19444-1476
Mailing Address - Country:US
Mailing Address - Phone:215-849-7700
Mailing Address - Fax:215-849-7631
Practice Address - Street 1:1 PENN BOULEVARD
Practice Address - Street 2:SUITE 3026
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19444-1476
Practice Address - Country:US
Practice Address - Phone:215-849-7700
Practice Address - Fax:215-849-7631
Is Sole Proprietor?:No
Enumeration Date:2009-02-23
Last Update Date:2009-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP010107363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health