Provider Demographics
NPI:1336659010
Name:DONNELLY, EILEEN THERESA (FNP-C)
Entity Type:Individual
Prefix:
First Name:EILEEN
Middle Name:THERESA
Last Name:DONNELLY
Suffix:
Gender:F
Credentials:FNP-C
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:6800 PARK TEN BLVD STE 200S
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78213-4293
Mailing Address - Country:US
Mailing Address - Phone:210-261-1060
Mailing Address - Fax:210-261-1821
Practice Address - Street 1:1954 E HOUSTON ST RM 201
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78202-2953
Practice Address - Country:US
Practice Address - Phone:210-419-3076
Practice Address - Fax:210-261-3741
Is Sole Proprietor?:No
Enumeration Date:2017-10-06
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXAP135350363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care