Healthcare Provider Details

I. General information

NPI: 1144309998
Provider Name (Legal Business Name): DANA CAROL SPROTT FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/03/2006
Last Update Date: 04/07/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

820 E. MCCART ST., STE. A.
KRUM TX
76249
US

IV. Provider business mailing address

P.O. BOX 608
KRUM TX
76249
US

V. Phone/Fax

Practice location:
  • Phone: 940-482-6702
  • Fax: 940-482-9704
Mailing address:
  • Phone: 940-482-6702
  • Fax: 940-482-9704

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number597377
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR0096598
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: