Provider Demographics
NPI:1548607351
Name:DOUGLAS, ELANDA LACHELLE (DNP, APRN, FNP-BC)
Entity Type:Individual
Prefix:DR
First Name:ELANDA
Middle Name:LACHELLE
Last Name:DOUGLAS
Suffix:
Gender:F
Credentials:DNP, APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6053 MAIN ST STE 110
Mailing Address - Street 2:
Mailing Address - City:THE COLONY
Mailing Address - State:TX
Mailing Address - Zip Code:75056-4708
Mailing Address - Country:US
Mailing Address - Phone:972-872-8865
Mailing Address - Fax:
Practice Address - Street 1:6053 MAIN ST STE 110
Practice Address - Street 2:
Practice Address - City:THE COLONY
Practice Address - State:TX
Practice Address - Zip Code:75056-4708
Practice Address - Country:US
Practice Address - Phone:972-872-8865
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-03
Last Update Date:2022-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX666027363LF0000X
TXAP123659363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily