Provider Demographics
NPI:1861594939
Name:WHALEY, DONNA M (CRNP)
Entity type:Individual
Prefix:MS
First Name:DONNA
Middle Name:M
Last Name:WHALEY
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 LEE ROAD 265
Mailing Address - Street 2:
Mailing Address - City:CUSSETA
Mailing Address - State:AL
Mailing Address - Zip Code:36852-2944
Mailing Address - Country:US
Mailing Address - Phone:334-276-9500
Mailing Address - Fax:888-527-5911
Practice Address - Street 1:410 LEE ROAD 265
Practice Address - Street 2:
Practice Address - City:CUSSETA
Practice Address - State:AL
Practice Address - Zip Code:36852-2944
Practice Address - Country:US
Practice Address - Phone:334-275-9500
Practice Address - Fax:888-527-5911
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1085743363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALQ68175Medicare UPIN
AL051557509Medicare ID - Type Unspecified