Provider Demographics
NPI:1477574390
Name:RACINSKAS, DANA ADELE (NP)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:ADELE
Last Name:RACINSKAS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7441 MARVIN D LOVE FWY
Mailing Address - Street 2:300
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75237-3490
Mailing Address - Country:US
Mailing Address - Phone:469-583-3262
Mailing Address - Fax:
Practice Address - Street 1:7441 MARVIN D LOVE FWY
Practice Address - Street 2:300
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75237-3490
Practice Address - Country:US
Practice Address - Phone:469-583-3262
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-23
Last Update Date:2009-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX578227363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health