Provider Demographics
NPI:1275615130
Name:NANCE, DONALD L (CRNA)
Entity Type:Individual
Prefix:MR
First Name:DONALD
Middle Name:L
Last Name:NANCE
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:930 VIA LINDA CT
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-2659
Mailing Address - Country:US
Mailing Address - Phone:915-760-8248
Mailing Address - Fax:
Practice Address - Street 1:5005 NO. PIEDRAS ST.
Practice Address - Street 2:WBAMC
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79920-5001
Practice Address - Country:US
Practice Address - Phone:915-569-1058
Practice Address - Fax:915-569-1027
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX596130367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered