Provider Demographics
NPI:1518028463
Name:DONALD, SHIRLEY A (RN)
Entity Type:Individual
Prefix:
First Name:SHIRLEY
Middle Name:A
Last Name:DONALD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 CENTRAL DR
Mailing Address - Street 2:SUITE 160
Mailing Address - City:BEDFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76022-6000
Mailing Address - Country:US
Mailing Address - Phone:817-268-0104
Mailing Address - Fax:817-268-6102
Practice Address - Street 1:1600 CENTRAL DR
Practice Address - Street 2:SUITE 160
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76022-6000
Practice Address - Country:US
Practice Address - Phone:817-268-0104
Practice Address - Fax:817-268-6102
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2012-07-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX648875163WP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0000XNursing Service ProvidersRegistered NursePain Management