Basic Information
| Provider Information | |||||||||
| NPI: | 1821194960 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | STEADMAN | ||||||||
| FirstName: | DONNA | ||||||||
| MiddleName: | FORGAY | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 401 W DECATUR ST | ||||||||
| Address2: | |||||||||
| City: | MADISON | ||||||||
| State: | NC | ||||||||
| PostalCode: | 270251913 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3365489618 | ||||||||
| FaxNumber: | 3365484877 | ||||||||
| Practice Location | |||||||||
| Address1: | 401 W DECATUR ST | ||||||||
| Address2: | |||||||||
| City: | MADISON | ||||||||
| State: | NC | ||||||||
| PostalCode: | 270251913 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3365489618 | ||||||||
| FaxNumber: | 3365484877 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/16/2006 | ||||||||
| LastUpdateDate: | 01/11/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | 900037 | NC | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
ID Information
| ID | Type | State | Issuer | Description | 2594479A | 01 | NC | MEDICARE | OTHER | 1821194960 | 01 | NC | NC BLUE CROSS | OTHER |