Provider Demographics
NPI:1073701728
Name:PRICHARD, DONNA MICHELE (RN, ANP-BC)
Entity Type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:MICHELE
Last Name:PRICHARD
Suffix:
Gender:F
Credentials:RN, ANP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12553 GULF FWY
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77034-4509
Mailing Address - Country:US
Mailing Address - Phone:281-481-8557
Mailing Address - Fax:281-484-7916
Practice Address - Street 1:12553 GULF FWY
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77034-4509
Practice Address - Country:US
Practice Address - Phone:281-481-8557
Practice Address - Fax:281-484-7916
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-09
Last Update Date:2014-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX655002363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX206637501Medicaid
TX206637501Medicaid