Provider Demographics
NPI:1346689494
Name:PERLOWSKI, DANNA LEA (RN/FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:DANNA
Middle Name:LEA
Last Name:PERLOWSKI
Suffix:
Gender:F
Credentials:RN/FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 RABBIT HL
Mailing Address - Street 2:
Mailing Address - City:LORENA
Mailing Address - State:TX
Mailing Address - Zip Code:76655-3077
Mailing Address - Country:US
Mailing Address - Phone:254-366-0330
Mailing Address - Fax:
Practice Address - Street 1:3305 101ST ST STE 100
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79423-4076
Practice Address - Country:US
Practice Address - Phone:806-771-0588
Practice Address - Fax:806-687-5966
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-21
Last Update Date:2020-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP123708363LF0000X
TX547135364SF0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No364SF0001XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistFamily Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX331451003Medicaid