Provider Demographics
NPI:1538335831
Name:NAUMANN, DONNA C (FNP)
Entity type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:C
Last Name:NAUMANN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MISS
Other - First Name:DONNA
Other - Middle Name:C
Other - Last Name:HEIDBRINK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:506 IMPERIAL DR
Mailing Address - Street 2:
Mailing Address - City:O FALLON
Mailing Address - State:MO
Mailing Address - Zip Code:63366-2131
Mailing Address - Country:US
Mailing Address - Phone:636-379-3456
Mailing Address - Fax:
Practice Address - Street 1:3533 DUNN RD
Practice Address - Street 2:STE. 205
Practice Address - City:FLORISSANT
Practice Address - State:MO
Practice Address - Zip Code:63033-6761
Practice Address - Country:US
Practice Address - Phone:314-831-2600
Practice Address - Fax:314-831-5393
Is Sole Proprietor?:No
Enumeration Date:2008-05-06
Last Update Date:2008-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO105339163W00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOAPPLYINGMedicaid
MOAPPLYINGMedicaid
MONAMedicare UPIN