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General NPI Number Information
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NPI Number | 1639205545
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Entity Type | Individual
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Provider Name | ELLEN DONNELLY PMH- NP
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Gender | Female
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Dates
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Enumeration Date | 02/26/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 9525 KATY FWY SUITE 312
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City | HOUSTON
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State | TX
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Zip | 77024-1407
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Country | US
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Telephone | 713-463-9449
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Fax | 716-463-7181
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Provider Business Mailing Address
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Address Line | 9525 KATY FWY SUITE 312
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City | HOUSTON
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State | TX
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Zip | 77024-1407
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Country | US
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Telephone | 713-463-9449
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Fax | 716-463-7181
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 654876
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License Number State | TX
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