Basic Information
Provider Information
NPI: 1407019268
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MCDONAGH-ZEIGLER
FirstName: PATRICIA
MiddleName: D
NamePrefix: MRS.
NameSuffix:  
Credential: ACNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 402145
Address2:  
City: ATLANTA
State: GA
PostalCode: 303842145
CountryCode: US
TelephoneNumber: 8032967306
FaxNumber:  
Practice Location
Address1: 3 RICHLAND MEDICAL PARK DR
Address2: SUITE 510
City: COLUMBIA
State: SC
PostalCode: 292036849
CountryCode: US
TelephoneNumber: 8034346771
FaxNumber: 8034343955
Other Information
ProviderEnumerationDate: 07/02/2008
LastUpdateDate: 02/25/2009
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LA2100X3477SCY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care

ID Information
IDTypeStateIssuerDescription
NP131805SC MEDICAID


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