Provider Demographics
NPI:1790944353
Name:MCDONALD, MARY JOY (CPNP)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:JOY
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4320 LIAM DR
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-8429
Mailing Address - Country:US
Mailing Address - Phone:214-618-5337
Mailing Address - Fax:214-618-5337
Practice Address - Street 1:1935 MEDICAL DISTRICT DR
Practice Address - Street 2:CHILDREN'S MEDICAL CENTER - EMERGENCY CENTER
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75235-7701
Practice Address - Country:US
Practice Address - Phone:214-456-5100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-08
Last Update Date:2008-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX455429363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics