Provider Demographics
NPI:1679130207
Name:VONDENBOSCH, DONNA JAYNE (CRNP)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:JAYNE
Last Name:VONDENBOSCH
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 1:131 N 5TH ST
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19601-3415
Mailing Address - Country:US
Mailing Address - Phone:610-927-6213
Mailing Address - Fax:
Practice Address - Street 1:131 N 5TH ST
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19601-3415
Practice Address - Country:US
Practice Address - Phone:610-927-6213
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-20
Last Update Date:2019-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP020193363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health