Provider Demographics
NPI:1427838481
Name:MCDONALD, JOANNE MARIE (DNAP, CRNA)
Entity type:Individual
Prefix:MRS
First Name:JOANNE
Middle Name:MARIE
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:DNAP, CRNA
Other - Prefix:MISS
Other - First Name:JOANNE
Other - Middle Name:MARIE
Other - Last Name:GARCIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:17511 SUGAR BLUFF LN
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:TX
Mailing Address - Zip Code:75762
Mailing Address - Country:US
Mailing Address - Phone:214-385-1581
Mailing Address - Fax:
Practice Address - Street 1:800 E DAWSON ST
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75701-2036
Practice Address - Country:US
Practice Address - Phone:903-593-8441
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-05
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1137559367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered