| Doctor Name: | MS. DONNA M WACKER |
| NPI Number: | 1356431894 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP-C |
| License Number: | R26295 |
| Business Practice Address: | 615 6 St Se Mountrail County Medical Center Stanley, ND - 58784 |
| Business Phone Number: | 7016282505 |
| Business Fax Number: | 7016283274 |
| Mailing Address: | 1951 Main St W, TURTLE LAKE |
| State: | ND |
| Postal Code: | 585759661 |
| Phone Number: | 7016282505 |
| Fax Number: | 7016283274 |
| NPI Enumeration Date: | 10/13/2006 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | R26295 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ND |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |