Provider Demographics
NPI:1942257241
Name:DOUGLAS, BECKY ANN (RN, WHCNP)
Entity Type:Individual
Prefix:MRS
First Name:BECKY
Middle Name:ANN
Last Name:DOUGLAS
Suffix:
Gender:F
Credentials:RN, WHCNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7269 FERNMEADOW DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75248-5604
Mailing Address - Country:US
Mailing Address - Phone:972-490-3710
Mailing Address - Fax:
Practice Address - Street 1:8210 WALNUT HILL LN
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-4411
Practice Address - Country:US
Practice Address - Phone:214-345-2777
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX245298363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health