Healthcare Provider Details

I. General information

NPI: 1326081621
Provider Name (Legal Business Name): DONNA M READ ANP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/14/2006
Last Update Date: 11/19/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 N RIDGEWAY DR
CLEBURNE TX
76033-5118
US

IV. Provider business mailing address

505 N RIDGEWAY DR
CLEBURNE TX
76033-5118
US

V. Phone/Fax

Practice location:
  • Phone: 817-517-7336
  • Fax:
Mailing address:
  • Phone: 817-517-7336
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number434388
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: