Basic Information
Provider Information
NPI: 1114171238
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: AUER
FirstName: DONNA
MiddleName: LEE
NamePrefix:  
NameSuffix:  
Credential: NP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3621 S STATE ST
Address2: 700 KMS PLACE
City: ANN ARBOR
State: MI
PostalCode: 48108
CountryCode: US
TelephoneNumber: 7349362047
FaxNumber:  
Practice Location
Address1: 325 E EISENHOWER PLWY
Address2: SUITE 100
City: ANN ARBOR
State: MI
PostalCode: 481085744
CountryCode: US
TelephoneNumber: 7347635459
FaxNumber:  
Other Information
ProviderEnumerationDate: 11/17/2008
LastUpdateDate: 10/05/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363L00000X4704143988MIY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

No ID Information.


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