Provider Demographics
NPI:1992101091
Name:CAREY-TREANOR, KATHLEEN M
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:M
Last Name:CAREY-TREANOR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KATHLEEN
Other - Middle Name:MADELINE
Other - Last Name:CAREY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AGACNP
Mailing Address - Street 1:3410 WORTH ST 250
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75246-2073
Mailing Address - Country:US
Mailing Address - Phone:214-820-6856
Mailing Address - Fax:214-820-1474
Practice Address - Street 1:3410 WORTH ST
Practice Address - Street 2:SUITE #250
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75246-2003
Practice Address - Country:US
Practice Address - Phone:214-820-6856
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-17
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP126908363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care