Provider Demographics
NPI:1689004814
Name:RIDEAU, HALANA (MSN, RN, FNP-C)
Entity Type:Individual
Prefix:MS
First Name:HALANA
Middle Name:
Last Name:RIDEAU
Suffix:
Gender:F
Credentials:MSN, RN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 KITTERY DR
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-5206
Mailing Address - Country:US
Mailing Address - Phone:214-394-8847
Mailing Address - Fax:
Practice Address - Street 1:2200 DALLAS PKWY
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-4300
Practice Address - Country:US
Practice Address - Phone:214-394-8847
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-25
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX733229363LF0000X
KY3012518363LF0000X
ARA003982363LF0000X
TXAP124596363LP2300X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care