Provider Demographics
NPI:1801660741
Name:GRAHAM, DONNA LYNN (APRN - CNP)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:LYNN
Last Name:GRAHAM
Suffix:
Gender:F
Credentials:APRN - CNP
Other - Prefix:
Other - First Name:DONNA
Other - Middle Name:LYNN
Other - Last Name:MACK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1721 CITRUS DR
Mailing Address - Street 2:
Mailing Address - City:WESLACO
Mailing Address - State:TX
Mailing Address - Zip Code:78596-9595
Mailing Address - Country:US
Mailing Address - Phone:956-363-5974
Mailing Address - Fax:
Practice Address - Street 1:1010 S AIRPORT DR
Practice Address - Street 2:
Practice Address - City:WESLACO
Practice Address - State:TX
Practice Address - Zip Code:78596-6600
Practice Address - Country:US
Practice Address - Phone:956-969-2609
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-10
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1141398363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily