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NPI Code Detail

MEDICARE: MRS. BRENDA JEAN MCDONNELL AGPCNP-BC

MEDICARE:  MRS. BRENDA JEAN MCDONNELL  AGPCNP-BC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse PractitionerSP034269PA
2363L00000XNurse Practitioner1022615TX

General Provider Information

NPI Number : 1588331771
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. BRENDA JEAN MCDONNELL AGPCNP-BC
Provider Business Mailing Address
First Line : 800 MEDICAL CENTER DR
Second Line :
City : DECATUR
State : TX
Zip : 76234-3843
Country : US
Telephone Number : 940-626-2110
Fax Number : 940-626-2113
Provider Business Practice Location Address
First Line : 800 MEDICAL CENTER DR
Second Line :
City : DECATUR
State : TX
Zip : 76234-3843
Country : US
Telephone Number : 940-626-2110
Fax Number : 940-626-2113
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/25/2021
Last Update Date : 03/08/2026

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Directions to “ MRS. BRENDA JEAN MCDONNELL AGPCNP-BC” Practice Location

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