Provider Demographics
NPI:1295867034
Name:O'TOOLE, DONNA GAYLE (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:GAYLE
Last Name:O'TOOLE
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 1:1122 E AUSTIN ST
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:TX
Mailing Address - Zip Code:75460-0424
Mailing Address - Country:US
Mailing Address - Phone:903-783-1999
Mailing Address - Fax:903-783-1167
Practice Address - Street 1:1122 E AUSTIN ST
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:TX
Practice Address - Zip Code:75460-0424
Practice Address - Country:US
Practice Address - Phone:903-783-1999
Practice Address - Fax:903-783-1167
Is Sole Proprietor?:No
Enumeration Date:2007-03-09
Last Update Date:2016-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX227977363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8Y2009OtherBLUE CROSS BLUE SHIELD
TX191035801Medicaid
TX8Y2009OtherBLUE CROSS BLUE SHIELD