Provider Demographics
NPI:1376741850
Name:STUMP, DONNA SUE (RN)
Entity type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:SUE
Last Name:STUMP
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26316 LEGACY CT
Mailing Address - Street 2:
Mailing Address - City:HEMET
Mailing Address - State:CA
Mailing Address - Zip Code:92544-6678
Mailing Address - Country:US
Mailing Address - Phone:951-927-3565
Mailing Address - Fax:
Practice Address - Street 1:26316 LEGACY
Practice Address - Street 2:
Practice Address - City:HEMET
Practice Address - State:CA
Practice Address - Zip Code:92544-6678
Practice Address - Country:US
Practice Address - Phone:951-927-3565
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA602822163WN0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WN0002XNursing Service ProvidersRegistered NurseNeonatal Intensive Care