Provider Demographics
NPI:1922564798
Name:WHITE, DONA CHIMENE (AG ACNP)
Entity Type:Individual
Prefix:
First Name:DONA
Middle Name:CHIMENE
Last Name:WHITE
Suffix:
Gender:F
Credentials:AG ACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11908 ANDERSON MILL RD APT 815
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78726-1126
Mailing Address - Country:US
Mailing Address - Phone:225-205-1707
Mailing Address - Fax:
Practice Address - Street 1:6010 W AMARILLO BLVD
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-1990
Practice Address - Country:US
Practice Address - Phone:806-354-7856
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-15
Last Update Date:2019-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP139952363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care