Provider Demographics
NPI:1902052954
Name:PARDUE, DONISHA DAWN (NP)
Entity Type:Individual
Prefix:MS
First Name:DONISHA
Middle Name:DAWN
Last Name:PARDUE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:DONISHA
Other - Middle Name:
Other - Last Name:LAPIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:815 RIVERVIEW DR
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:AL
Mailing Address - Zip Code:35630-5927
Mailing Address - Country:US
Mailing Address - Phone:603-957-0540
Mailing Address - Fax:
Practice Address - Street 1:3606 E BASELINE RD
Practice Address - Street 2:#209
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85042-7202
Practice Address - Country:US
Practice Address - Phone:603-957-0540
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-11
Last Update Date:2016-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP3181363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily