Provider Demographics
NPI:1629578679
Name:DANCER, DONNA ARLEEN (LVN,143566)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:ARLEEN
Last Name:DANCER
Suffix:
Gender:F
Credentials:LVN,143566
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:348 COUNTY ROAD 433
Mailing Address - Street 2:
Mailing Address - City:CHIRENO
Mailing Address - State:TX
Mailing Address - Zip Code:75937-3705
Mailing Address - Country:US
Mailing Address - Phone:936-362-2173
Mailing Address - Fax:
Practice Address - Street 1:348 COUNTY ROAD 433
Practice Address - Street 2:
Practice Address - City:CHIRENO
Practice Address - State:TX
Practice Address - Zip Code:75937-3705
Practice Address - Country:US
Practice Address - Phone:936-362-2173
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-16
Last Update Date:2018-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX143566164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse