Provider Demographics
NPI:1548542129
Name:FIEDLER, DONNA M (REGISTERED NURSE)
Entity type:Individual
Prefix:MS
First Name:DONNA
Middle Name:M
Last Name:FIEDLER
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:73 PHEASANT RUN
Mailing Address - Street 2:
Mailing Address - City:OLD TAPPAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07675-7466
Mailing Address - Country:US
Mailing Address - Phone:201-563-3536
Mailing Address - Fax:
Practice Address - Street 1:73 PHEASANT RUN
Practice Address - Street 2:
Practice Address - City:OLD TAPPAN
Practice Address - State:NJ
Practice Address - Zip Code:07675-7466
Practice Address - Country:US
Practice Address - Phone:201-563-3536
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-09
Last Update Date:2011-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NO07788300163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse