Basic Information
| Provider Information | |||||||||
| NPI: | 1538134705 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | STUBBS | ||||||||
| FirstName: | DONNA | ||||||||
| MiddleName: | CUNNINGHAM | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | CRNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 900 ELKRIDGE LANDING RD FL 2 | ||||||||
| Address2: | |||||||||
| City: | LINTHICUM | ||||||||
| State: | MD | ||||||||
| PostalCode: | 210902924 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4434625010 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 490 CADMUS LN STE 104 | ||||||||
| Address2: | |||||||||
| City: | EASTON | ||||||||
| State: | MD | ||||||||
| PostalCode: | 216014091 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4108200560 | ||||||||
| FaxNumber: | 4108200564 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/21/2006 | ||||||||
| LastUpdateDate: | 03/05/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/05/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | R081602 | MD | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
ID Information
| ID | Type | State | Issuer | Description | 521116591 | 01 | MD | TRICARE | OTHER | 784381000 | 05 | MD | MEDICAID | 521116591 | 01 | MD | MARYLAND PHYSICIANS CARE | OTHER | 656205 | 01 | MD | COVENTRY | OTHER | 737191 | 01 | MD | NCPPO | OTHER | 75868003 | 01 | MD | CAREFIRST BC/BS RENDERING | OTHER | 015537 | 01 | MD | PRIORITY PARTNERS | OTHER | T5880024 | 01 | MD | CF BC/BS GRP/GHMSI/BL CHO | OTHER | 521116591 | 01 | MD | INFORMED | OTHER | 6513545 | 01 | MD | CIGNA | OTHER |