Provider Demographics
NPI:1841792702
Name:DANIELS, DONNA KAY (FNP-C)
Entity Type:Individual
Prefix:MS
First Name:DONNA
Middle Name:KAY
Last Name:DANIELS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1515 LAWSON RD
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75181-1925
Mailing Address - Country:US
Mailing Address - Phone:214-236-9300
Mailing Address - Fax:
Practice Address - Street 1:568 N 4TH ST
Practice Address - Street 2:
Practice Address - City:WILLS POINT
Practice Address - State:TX
Practice Address - Zip Code:75169-1616
Practice Address - Country:US
Practice Address - Phone:903-873-3330
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-06
Last Update Date:2018-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP135491363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner