Provider Demographics
NPI:1699659581
Name:DONOHUE, MATTHEW VINCENT
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:VINCENT
Last Name:DONOHUE
Suffix:
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:MATTHEW
Other - Middle Name:
Other - Last Name:DONOHUE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1009 S DEWEY ST APT 316
Mailing Address - Street 2:
Mailing Address - City:NORTH PLATTE
Mailing Address - State:NE
Mailing Address - Zip Code:69101-6112
Mailing Address - Country:US
Mailing Address - Phone:469-545-8505
Mailing Address - Fax:
Practice Address - Street 1:675 HALLIGAN DR
Practice Address - Street 2:
Practice Address - City:NORTH PLATTE
Practice Address - State:NE
Practice Address - Zip Code:69101-7656
Practice Address - Country:US
Practice Address - Phone:208-252-1022
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-04
Last Update Date:2025-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide