Provider Demographics
NPI:1144536988
Name:DONOVAN, ERIN (LMT)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:DONOVAN
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3413 CRESCENT RDG
Mailing Address - Street 2:
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52003-5234
Mailing Address - Country:US
Mailing Address - Phone:563-581-1319
Mailing Address - Fax:
Practice Address - Street 1:3413 CRESCENT RDG
Practice Address - Street 2:
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52003-5234
Practice Address - Country:US
Practice Address - Phone:563-581-1319
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-30
Last Update Date:2010-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA03980174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist