=====================================================
General NPI Number Information
=====================================================
NPI Number | 1376542589
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | NONA DARLENE ADDISON MENN N.P.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/19/2005
-----------------------------------------------------
Last Update Date | 03/07/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 301 S SAN PATRICIO ST SUITE # C
-----------------------------------------------------
City | SINTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78387-2432
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 361-438-6502
-----------------------------------------------------
Fax | 361-368-2574
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 1137
-----------------------------------------------------
City | ODEM
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78370-1137
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 361-438-6502
-----------------------------------------------------
Fax | 361-368-2574
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 163W00000X
-----------------------------------------------------
Taxonomy Name | Registered Nurse
-----------------------------------------------------
License Number | 20986
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363L00000X
-----------------------------------------------------
Taxonomy Name | Nurse Practitioner
-----------------------------------------------------
License Number | 20986
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 363LP2300X
-----------------------------------------------------
Taxonomy Name | Primary Care Nurse Practitioner
-----------------------------------------------------
License Number | 20986
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------
Taxonomy #4
-----------------------------------------------------
Taxonomy Code | 363LW0102X
-----------------------------------------------------
Taxonomy Name | Women's Health Nurse Practitioner
-----------------------------------------------------
License Number | 20986
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------
Taxonomy #5
-----------------------------------------------------
Taxonomy Code | 363LX0001X
-----------------------------------------------------
Taxonomy Name | Obstetrics & Gynecology Nurse Practitioner
-----------------------------------------------------
License Number | 20986
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------