Provider Demographics
NPI:1679069157
Name:DONAHUE, ANNA WOODWARD (APRN)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:WOODWARD
Last Name:DONAHUE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13450 NW 104TH TER STE B
Mailing Address - Street 2:
Mailing Address - City:ALACHUA
Mailing Address - State:FL
Mailing Address - Zip Code:32615-5608
Mailing Address - Country:US
Mailing Address - Phone:352-757-2711
Mailing Address - Fax:
Practice Address - Street 1:13450 NW 104TH TER
Practice Address - Street 2:
Practice Address - City:ALACHUA
Practice Address - State:FL
Practice Address - Zip Code:32615-5608
Practice Address - Country:US
Practice Address - Phone:352-757-2711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-07
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9473943363LG0600X
FLAG06180195363LG0600X
FL9473943363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology