Provider Demographics
NPI:1841266939
Name:GURICA, DONNA FAY (FNP)
Entity type:Individual
Prefix:MS
First Name:DONNA
Middle Name:FAY
Last Name:GURICA
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MS
Other - First Name:DONNA
Other - Middle Name:TUCKER
Other - Last Name:GURICA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FNP
Mailing Address - Street 1:600 TOWNLEY DR
Mailing Address - Street 2:
Mailing Address - City:EVERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:76140-5206
Mailing Address - Country:US
Mailing Address - Phone:817-551-6504
Mailing Address - Fax:817-568-2795
Practice Address - Street 1:600 TOWNLEY DR
Practice Address - Street 2:
Practice Address - City:EVERMAN
Practice Address - State:TX
Practice Address - Zip Code:76140-5206
Practice Address - Country:US
Practice Address - Phone:817-551-6504
Practice Address - Fax:817-568-2795
Is Sole Proprietor?:No
Enumeration Date:2006-02-27
Last Update Date:2012-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX233753363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
8Y3046OtherBCBS
TX10068745OtherAMERIGROUP
TX8J7772Medicaid
TX10068745OtherAMERIGROUP