Provider Demographics
NPI:1447213293
Name:ENDERLE, DONNA R (RNC, NNP, CPNP)
Entity Type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:R
Last Name:ENDERLE
Suffix:
Gender:F
Credentials:RNC, NNP, CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3500 GASTON AVE
Mailing Address - Street 2:NEONATOLOGY/3 HOB
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75248
Mailing Address - Country:US
Mailing Address - Phone:972-965-6927
Mailing Address - Fax:
Practice Address - Street 1:BAYLOR HOSPITAL - 3 HOB
Practice Address - Street 2:3500 GASTON AVENUE
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75248
Practice Address - Country:US
Practice Address - Phone:214-820-2806
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-11
Last Update Date:2007-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX533187363LN0005X, 363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0005XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal, Critical Care
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics