Physician Compare National (NPI:1386030864)

HEALTHCARE PROVIDER: JOLLYNN DOANNE FNP

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1386030864
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	5698094274
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20150504000136
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	DOANNE
	Individual professional last name
Provider First Name	JOLLYNN
	Individual professional first name
Provider Middle Name	KIM
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	2014
	Individual professional's medical school graduation year
Primary Specialty	NURSE PRACTITIONER
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	SENIOR PSYCHCARE OF SAN ANTONIO I PLLC
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	8628241544
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	16
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	6849 CRESTWAY DR
	Group Practice or individual's line 1 address
City	SAN ANTONIO
	Group Practice or individual's city
State	TX
	Group Practice or individual's state
Zip Code	782392321
	Group Practice or individual's zip code (9 digits when available)
Phone Number	2109464994
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y