Provider Demographics
NPI:1164918629
Name:DONOSO, MELISSA CRAIN (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:CRAIN
Last Name:DONOSO
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1648 OLD RANCH RD
Mailing Address - Street 2:
Mailing Address - City:CHINA SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:76633-3212
Mailing Address - Country:US
Mailing Address - Phone:254-836-9559
Mailing Address - Fax:
Practice Address - Street 1:318 RICHLAND WEST CIR
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76712-7919
Practice Address - Country:US
Practice Address - Phone:254-776-8008
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-09
Last Update Date:2018-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX818532363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
F05180168OtherAMERICAN ACADEMY OF NURSE PRACTITIONERS
TX818532OtherTEXAS BOARD OF NURSING