Provider Demographics
NPI:1376542589
Name:MENN, NONA DARLENE ADDISON (NP)
Entity Type:Individual
Prefix:MRS
First Name:NONA
Middle Name:DARLENE ADDISON
Last Name:MENN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MRS
Other - First Name:DARLENE
Other - Middle Name:ADDISON
Other - Last Name:MENN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NP
Mailing Address - Street 1:PO BOX 1137
Mailing Address - Street 2:
Mailing Address - City:ODEM
Mailing Address - State:TX
Mailing Address - Zip Code:78370-1137
Mailing Address - Country:US
Mailing Address - Phone:361-438-6502
Mailing Address - Fax:361-368-2574
Practice Address - Street 1:301 S SAN PATRICIO ST
Practice Address - Street 2:SUITE # C
Practice Address - City:SINTON
Practice Address - State:TX
Practice Address - Zip Code:78387-2432
Practice Address - Country:US
Practice Address - Phone:361-438-6502
Practice Address - Fax:361-368-2574
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-19
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX20986163W00000X, 363L00000X, 363LP2300X, 363LW0102X, 363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0291OtherTSBNE LPA#
TX20986OtherTSBNE #
TX029339101Medicaid
TX029339102Medicaid
TXB0141068OtherDPS REGISTRATION
TX45D1039042OtherCLIA
TXMM1357373OtherDEA
TX20986OtherTSBNE #
TXP 18578Medicare UPIN